Renee Dickerson dissertation

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Institute for Clinical Social Work

Psychodynamic Understanding of Military Sexual Trauma

A Dissertation Submitted to the Faculty of the Institute for Clinical Social Work in Partial Fulfillment

for the Degree of Doctor of Philosophy

Chicago, Illinois

August 24, 2022

Copyright © 2022

All rights reserved

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Abstract

This research study examines the nuances of the lived experience of eight female military sexual trauma survivors, utilizing interpretative phenomenological analysis as the qualitative methodology. Interpretative phenomenological analysis was used to address the nuances of the experiences of these survivors and to explore in detail how they made sense of their internal worlds after experiencing their military trauma. As a result of the interviews, eight themes emerged. The themes that emerged are: Basic or boot camp training where the contract and indoctrination begins; enthusiastically joining the military for a better life; government property, man’s property; the dehumanizing effects of military sexual trauma; the loss of enthusiasm for being in the military and feeling broken; and willful ignorance on the part of the military. Based on the data derived from the participants and the themes that emerged, the psychodynamic theory chosen to explain how the participants internalized their traumatic experiences, both intrapsychically and interpersonally, is Marvin Hurvich’s (1989) annihilation anxiety theory. This study offers therapists in social work and mental health insight into the lived experiences of military sexual trauma survivors and the longterm resulting effects.

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In memory of Simon Sulaica, Ngozi Okafor Smith, and Vincent Anyaso.

To all survivors of military sexual trauma, your contribution and service matters.

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It was an astounding admission when Sen. John McCain (2013), R-Ariz., confessed that he had advised the mother of a young woman interested in joining the military that he couldn’t in all good faith tell her it was the right career path for her daughter. McCain wasn’t faulting the military for lack of opportunity, or for gender discrimination, but for something far more basic, the continued inability to protect service women, and men too, from sexual assault, and to give those who are the victims of assault or sexual harassment a fair hearing without fear of retribution.

John McCain (2013; Zaleski, 2015)

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Acknowledgments

Dr. Ridings, thank you for approving this research topic. Your rigorous questioning on how I should proceed was constructive and prepared me for the challenges and bureaucratic roadblocks you knew I would eventually encounter. Dr. James Lampe, you are a sagacious mentor who guided me through this academic journey. Millie Ray, thank you for supporting and guiding me through my writing development. You showed me how to honor the women who participated in this study. Your efforts helped ensure that I clearly and carefully told their stories. To Anisha Bolden, publish your poetry! Your poems provide crystal clear clarity about “the military experience.” I will always be grateful to you for showing me how to listen to women warriors. To the women who participated in this study, please know that you were co-researchers with me, and I could not have completed this project without you. Thank you

RFD

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Abstract…………….…………………………………………………..……..…………iii
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Table of Contents Page
Acknowledgements ……………vi List of Tables x List of Abbreviations
..xi Chapter I. Introduction
1 Statement of Purpose Significance of the Study for Clinical Social Work Problem Statement Research Question Operational Definitions Statement of Assumptions Epistemological Foundation of the Project Foregrounding II. Literature Review
..
21 Introduction How MST Finally Came to the Public’s Attention and Its Continued Existence

Chapter Page

The Definition of Military Sexual Assault and Harassment

The Challenges of Reporting MST Crimes

Military Culture and the Rape Subculture

Short and Long-Term Effects of MST

The Interpersonal and Intrapsychic Experiences of Women MST Survivors

Conclusion

III. Methodology

Introduction

Rationale for Qualitative Research Design

Rationale for IPA Research Sample Research Design

Data Collection

Plan for Data Analysis

Ethical Considerations

Issues of Trustworthiness for Qualitative or Mixed Methods

Limitations

The Role and Background of the Researcher

IV. Results .86

Introduction

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Table of Contents Continued
…………………………………………..……………...…………60

Introduction

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Table of Contents Continued
Where It All Begins: The Contract and Indoctrination
of the Participants
V. Discussion and Conclusion 172
of Findings
Major Findings
Theoretical Interpretation
of the Study Future Research Clinical Implications for Social Work Practices Conclusion Appendices A. Participants and Flyer………………………………………………………...206 B. Initial Phone Contact…………….………..……………………………….….209 C. Welcome Email...................................................................................................212 D. Information Packet............................................................................................215 E. Interview Questions .....217 References 220
The Participants Study Results and Themes Summary of Themes
Discussion
The
Psychodynamic
Limitations

List of Tables Table

1. Description of the Participants.......................................

Page

2. Types of Discharges, Perpetrators, and History of Retaliation or Institutional Betrayal................................. 94

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…..…...………...93

List of Abbreviations

ACT Acceptance and commitment therapy

CBT Cognitive behavioral therapy

CPT Cognitive processing therapy

DMDC Defense Manpower Data Center

DoD Department of Defense

EMDR Eye movement desensitization reprocessing

HCVA House Committee on Veterans’ Affairs

MST Military sexual trauma

NSVRC National Sexual Violence Resource Center

OTH Other-than-honorable

PE Prolonged exposure

POW Prisoner of war

PTSD Post traumatic stress disorder

SAPRO Sexual Assault Prevention and Response Office

THOT That “hoe” over there/that “hoe” out there

UCMJ Uniform Code of Military Justice

USC United States Code

VA Veterans’ Affairs

VHA Veterans’ Affairs Hospital Administration

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Chapter I Introduction

Statement of Purpose

Research has indicated that the crime of military sexual trauma (MST) is a prevalent problem in the military, which has long-term and detrimental effects on both male and female survivors. Several high-profile criminal MST cases over the last 30 years have led to the commissioning of multiple research and review boards to investigate the systemic problem of sexual crimes in the military and the development of supportive programs and evidence-based treatment to assist survivors, all funded by billions of taxpayer dollars. Despite these efforts, MST is still pervasive and the retention rate of women in the military is drastically low because of the military’s inability to keep women safe (GAO Report, 2020; SAPR, 2020; 2021).

As a result of MST, women survivors experience a variety of psychological, medical, relational, and socio-economic challenges, and suicidal behavior (Monteith et al., 2019). Women survivors are desperately in need of mental health treatment to address the adult-onset trauma they experienced in the military. Currently, the mental health treatments recommended to address MST are those referred to as evidence-based therapies: cognitive behavioral therapy (CBT), eye movement desensitization reprocessing (EMDR), acceptance and commitment therapy (ACT), dialectical behavior

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therapy (DBT), cognitive processing therapy (CPT), and prolonged exposure (PE) therapy.

These evidence-based therapies focus on the patient’s thoughts and behaviors associated with the trauma with the idea that if you change the thoughts, you can change unproductive coping behaviors such as alcohol and drug abuse, gambling, and other highrisk behaviors. Because these evidence-based approaches focus on the patient’s thoughts and behaviors, they can be considered strictly psychological. In addition, these evidencebased approaches tend to be highly structured with the therapist focusing on one trauma at a time for a predetermined number of sessions.

Even though these evidence-based approaches can be useful, they are limited (Boulanger, 2020; Cushman, 2015; Spermon et al., 2010). The number of sessions is limited, often with as few as 12 to 16 sessions (Management of Posttraumatic Stress Disorder Work Group, 2017; Mead, 2019). In addition, since they are considered strictly psychological, it means that they do not address how the traumatic event has been internalized in both the mind and body of the patient. As a result of these limitations, the patients are unable to fully explore their traumas and how they are related to one another. This is crucial, if trauma is not addressed both psychologically and emotionally, MST survivors are not given the opportunity to heal mentally and emotionally (e.g., emotional pain, dysphoria, anxiety, sexual dysfunction, gastric-intestinal challenges, racing heart rate, and body aches and pains; Clements, 2004).

Psychological approaches can provide patients cognitive tools and insight into their trauma; however, these tools can leave emotional deficits unaddressed, which eventually affects the patient physiologically (Brignone et al., 2016; Chivers-Wilson, 2006; Gibson

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et al., 2016; Lofgreen et al., 2017; McCall-Hosenfeld et al., 2009; Turchik & Wilson, 2010; White et al., 2010; United States Congress [USC] and House Committee on Veterans’ Affairs [HCVA], 20122012) Including evidence-based practices with psychodynamic approaches results in the survivor better understanding herself and being better understood by the therapist thereby improving the treatment outcome (Cushman, 2015; Spermon et al., 2010).

In order to provide a more effective approach to treating MST survivors, psychodynamic therapies should be included in combination with evidence-based approaches and in accordance with the unique needs of the patient. Psychodynamic approaches should be considered, because psychoanalytic contributions led the way to understanding war related trauma during WWI (Boulanger 2007,, 2020; Shelby, 2015). Psychodynamic approaches have been effective in improving trauma-related diagnoses and other psychiatric symptomatology, interpersonal relationships, and social role functioning (Cushman, 2015; Spermon et al., 2010). These approaches can support evidence-based approaches and provide effective treatment therapies on their own (2015; 2010). Patients can benefit from psychodynamic approaches because people receiving psychodynamic treatment tend to stay in treatment longer which increases the chances that they will be able to manage and process their treatment experiences. Psychodynamic approaches are focused on the mind and body connection of the survivor, and they encourage patients to freely talk about their thoughts and feelings, including their desires and fears.

Even though there is a case to be made that psychodynamic approaches can be beneficial for survivors of MST, there is currently a lack of data on the lived experiences

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of the survivors. The first step in learning how to apply psychodynamic approaches to best address trauma is hearing and learning from survivors. Hearing from MST survivors about how they have internalized their trauma provides needed information on how to apply psychodynamic approaches with this population. This project aims to understand the lived experience of MST survivors.

The purpose of this qualitative phenomenological study is to explore and understand the meaning of MST from the lived experience of women who have served in the United States Armed Forces. The central phenomenon of this study is the meaning of the longterm effects of MST on female survivors, and how they are affected by the realization of the interpersonal and institutional betrayal their experience represents (Andersen et al., 2019; Gibson et al., 2016; Reinhardt et al., 2016), on intrapsychic and interpersonal levels. The interpretative phenomenological analysis is the qualitative methodology that will be utilized to address the nuances of the experiences of these survivors and to explore in detail how they make sense of their internal, personal, occupational, and social worlds.

The following definitions will provide a contextual frame for understanding the approach of this project. The terminology often used by the Department of Defense (DoD) and the Department of Veterans of Affairs (VA) to define sexual misconduct in its ranks is MST, which falls under the Federal Law Title 38 United States Code 1720D and 10 United States Code (USC) 920, Article 120 (2011b). MST refers to the experience of sexual harassment or assault of service members, by their peers or superiors, while serving in the military or during inactive duty service. MST is further defined as a psychological trauma that also includes repeated, unsolicited verbal or physical contact of

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a sexual nature that is threatening in character (USC 1720D; USC 920, 2019). MST occurs during deployments or during a time of peace, in any career field or place in the world. These incidents occur while military members are on duty or off duty, and are perpetrated by a superior, colleague, or subordinate.

The decision to concentrate on women rather than on men for this phenomenological study is based on the fact that incidences of MST are disproportionately high for the small percentage of women who serve in the military (Baltrushes & Karnik, 2013; Brownstone et al., 2018). Even though women make up less than 20% of the total force of the military, one-third has reported experiencing MST (Cichowski et al., 2019; Defense Manpower Data Center [DMDC], 2020). Even though male service members have endured greater numbers of MST-inducing incidents compared to female service members, this is attributable to the fact that there are far more males in the military, and they tend to report their MST incident far less than female members (Rosenthal & Korb, 2013). Current VA statistics reveal that 1 in 50 men report experiences of MST, 1 in 3 women in the military report such experiences (Cichowski et al., 2019; Morral et al., 2014).

In addition to the fact that women suffer a disproportionately higher rate of MST than men (Lucero, 2015), research has revealed that most men and women do not report their MST experience until they have left the military and they are not reliably treated for their trauma experience even when they seek help (Dardis el al., 2018; Mengeling et al., 2014; Rasmussen, 2016). Often veterans struggle on their own with their trauma experience until eventually going to the VA for medical treatment (2018; 462014; 2016). A history of MST can be revealed during a VA clinical appointment if the therapist

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assesses the history, but unfortunately this question is not reliably asked. It is unknown why the MST question is not consistently asked during VA appointments, but anecdotal evidence suggests that the question might be experienced as uncomfortable or shame inducing for the therapist. Also, sometimes the way in which a patient is asked about experiencing a history of MST may not be understood by the patient. Oftentimes, the patient assumes that MST only refers to physical assault because they believe that MST only refers to physical altercations.

Significance of the Study for Clinical Social Work

This study is significant for clinical social work because social workers, either civilian or in the military, may encounter female patients who may potentially have a prior military history and may have experienced MST, or other adult-onset traumas that are unknown to the therapist. Research studies find that, upon exiting from the military, only half of the women receive medical treatment at VA medical facilities (Cichowski et al., 2019). This finding suggests that at least half of the women who suffered MST while serving will not receive treatment to address their symptoms, which are directly related to their traumatic experience (2019). Consequently, if there is a confirmed history of MST, and it has been adversely internalized by the patient, this trauma remains hidden and unprocessed within the therapeutic setting. Typically, the therapeutic setting focuses on issues pertaining to the patient’s childhood or a current event without addressing the adult-onset trauma (Boulanger, 2007). The therapist’s neglect to assess for the military experience and symptoms, directly related to possible MST, may significantly impact the therapeutic process, and hinder the patient’s personal growth (2019).

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The analysis of the data compiled from the lived experience of female survivors of MST is expected to reveal an in-depth understanding of how they have internalized their trauma and how psychodynamic interventions may assist them in improving the quality of their lives both intrapsychically and interpersonally. By implication, the results may also aid in expanding the awareness within the psychodynamic community of the importance of asking a patient if she had ever been in the military service, assess if an MST history exists and explore with the patient how it had been internalized. The assessment of a military background and for a possible MST history, with the accompanying symptoms, may encourage the development of more appropriate treatment strategies. Moreover, the results may further aid the therapist in considering psychodynamic treatment strategies to assist in strengthening the survivor’s ability to connect and emotionally relate to the self and others (Burkhart & Hogan, 2015).

Another significant consideration is the necessity of social workers and psychotherapists and clinicians from all mental health disciplines to improve in their efforts to engage in socially responsible clinical practices in informing and educating other MST survivors who are not aware of and are not receiving treatment for their MST experience (Litz, 2014). An assessment can begin by asking if there is a prior military history, and then subsequently asking if the patient has experienced MST. The catastrophic and long-term effects of MST are too devastating to ignore, especially since the rate of women joining the military and, subsequently, becoming veterans is significantly increasing (Dever, 2019; Patten & Parker, 2011; Reynolds & Shendruk, 2018).

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Problem Statement

MST in the United States Armed Forces is a significant problem of epidemic proportions, and its effects are often catastrophic and life-lasting. The national data from the VA’s MST program reveals that 1 in 4 women and 1 in 100 men confirmed experiencing sexual assault or sex harassment while serving in the military (Cichowski et al., 2019; Morral et al., 2014; VA; VA, 2018). The military is male-dominated, and women represent only 18-20% of the total population, but they suffer disproportionately from symptoms of MST (Dever, 2019; DMDC, 2020; Lee, 2016). Because women suffer disproportionately, they are the focus of this study.

The military is also a microcosm of society and, similar to the general population, a culture of misogyny exists in the military (Lee, 2016; Rasmussen, 2016). Society’s attitudes and beliefs about sexually demeaning behavior and violence towards women, and the complacency and acceptance of sexual innuendos and jokes about rape, contribute to the misogynistic views and the tolerance of sexual misconduct in the military (Cernak, 2015; Lee, 2016; Lehner, 2018; Morral et al., 2014; Rasmussen, 2016;).;).Similar to society, the acceptance of the internalized beliefs about rape mythology, which blames the survivor, also exist in the military (Crall & Goodfriend, 2016; Lee, 2016; Lehner, 2018; Rosenthal, Rosenthal & Korb, 2013). Although there is a high occurrence of sexual misconduct in society, the structure and hierarchy of the military make it easier for perpetrators to hide amongst the rank and file and continue to violate (Cernak, 2015; Turchik & Wilson, 2009). Zaleski (2015) emphasizes that the military culture promotes a rape subculture which often idealizes masculine values (e.g.,

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strength, toughness, and restricted emotionality), and this endorses the domination and objectification of women.

MST, sexual harassment or sexual assault of service members, is unlawfully committed by their peers or superiors and by those in their chain of command, while serving in the military. MST incidents often occur where the service members live and work, and they must continue to live and work with the perpetrators after the incident (Brownstone et al., 2018; Rasmussen, 2016). Both men and women can be victims of MST, and both men and women can be perpetrators (Rasmussen, 2016).

As a consequence, men and women experience the long-lasting effects of sexual misconduct within the ranks, which includes physical, mental, emotional, and behavioral challenges (Gibson et al., 2016; Reinhardt et al.). The effects of MST can lead to the risk of survivors developing Post Traumatic Stress Disorder (PTSD), persistent negative thoughts and feelings (Carroll, 2018), depression and anxiety, (Goldstein et al., 2017; Turchik & Wilson 2010), substance abuse and dependence (Creech & Borsaria, 2014; Turchik & Wilson 2010), sexual dysfunction (McCall-Hosenfeld et al., 2009; Turchik & Wilson, 2010), suicidal ideation and attempts (McFarlane et al., 2005; Monteith et al., 2016; Turchik & Wilson 2010).

The medical concerns can range from cardiovascular (Gibson et al., 2016), neurological, gastrointestinal, and musculoskeletal challenges (White et al., 2010). MST can also damage the survivor’s ability to maintain interpersonal and intimate relationships (Turchik & Wilson, 2010). According to Andersen (2019), this suggests that there is a link between MST, sexual dysfunction, and institutional betrayal, because MST is an interpersonal trauma and a violent crime (2019).

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Oftentimes, service members choose not to report their MST incidents; this is mostly due to their fear of retaliation (Baltrushes & Karnik, 2013; Childress, 2015). As a result of the MST, the service member experiences a sense of betrayal by the military. The sense of betrayal is significantly magnified if there is continued harassment or a revictimization, if victim-blaming and shaming occur, or if he or she is unfavorably discharged after experiencing MST. Furthermore, if there is an unfavorable discharge from the military, the person is unable to secure viable employment and is not eligible to receive clinical or medical services from the VA, which was designed to help him or her (Castro et al., 2015). The veteran continues to be ineligible for services until he or she is ready to admit to experiencing MST to the VA hospital (Kimerling et al., 2007; USC 1720D). In other words, even if the veterans are otherwise ineligible to receive services, the veteran becomes eligible once they state that they experienced MST. Unfortunately, most veterans are unaware that they can receive MST-related VA services, even those who have been honorably discharged (2007). Also, because of the shame and guilt that is typically associated with the MST experience, the survivor is often unwilling to reveal that part of their life (Rasmussen, 2016).

Understanding how the survivor has internalized the MST experience feels not only essential but imperative. MST can severely affect the mental, emotional, and physical well-being of the survivors and may result in long-term problems, as the effects are often unrecognized and untreated, leaving survivors to suffer in silence (Grossman et al., 1997). Psychotherapists can help their patients process how the trauma and the military system impacted their inner world and help them find meaning beyond their personal and institutional betrayal experience.

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The problem to be studied is how female survivors are affected by their MST experience on intrapsychic and interpersonal levels as well as the effects on them as they continue to age. This study has four objectives:

1. The first objective is to gain a broader understanding of the long-term effects of the MST experience (e.g., misogynistic attitudes and practices, objectification, the perpetuation of the rape myth, victim-blaming, interpersonal and institutional betrayal, and the loss of military connectedness), and the impact it has on the lives of women who have served in the military.

2. The second objective is to learn about the complexities in determining whether or not to report an MST incident and the experience of receiving mental and medical services during and after leaving the military.

3. The third objective is to explore how the self-psychology theory may help frame the survivor’s intrapsychic and interpersonal MST experience and the institutional betrayal dynamics.

4. The final objective is to provide valuable insights into the long-term effects that female survivors of MST experience, especially as they continue to age and manage life challenges.

Research Question

This qualitative study is designed to address the following research questions:

1. What is the lived experience of female survivors of MST?

2. What are the effects of MST on them as they continue to age?

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3. How do women survivors see themselves in relation to the military, as an allpowerful structure, and their service to the United States?

4. How is MST internalized by the survivor?

This study will provide an exploration of the lived experience of women who were sexually harassed or sexually assaulted while serving in the military as well as the lingering intrapsychic and interpersonal effects as the women continue to age. The interpretative phenomenological analysis (IPA) is the methodology that will be used to explore how these female survivors of MST have internalized their subjective experiences.

Operational Definitions

For the purposes of this study, the following major concepts will be used: sexual assault) within the context of the institution (Monteith et al., 2016; Reinhardt et al., 2016).

• Military culture: The totality of all knowledge, beliefs, values, customs, habits, and capabilities about the military that is indoctrinated into service members. Members are regulated by forced assimilation (uniforms, marching, drilling, physical requirements, running in formation, following orders, military law, etc.). They are legally required to relinquish their personal privacy. Service members live, breathe, and move as a team. Camaraderie, esprit de corps, and group cohesiveness are drilled into the members to internalize the ideas of commitment to the mission, honor, and sacrificing oneself for the greater good, “the country.”

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Peer pressure is encouraged, and individualism is not tolerated (Meyer et al., 2016).

• Military Sexual Trauma (MST): MST is classified as a major criminal sexual violence offense, against current military members, entailing sexual assault as intentional sexual contact characterized by the use of force, threats, intimidation/harassment, or abuse of authority or when the victim does not or cannot consent (USC 1720D; USC 920, 2019). Perpetrators can be peers, superiors, men, or women. MST often occurs where military members live and work (USC 1720D; USC 920, 2019).

• Misogyny: Misogyny is defined as hatred of women (Merriam-Webster, 2019a).

• Rape myth acceptance: Male-on-female sexual violence typically focuses on cognitive distortions that manifest as “rape supportive attitudes;” attitudes that facilitate the justification of sexual violence, often serving to blame the victim, to exonerate the perpetrator, to minimize claims of rape, or to suggest that only certain types of women are raped (Yapp & Quayle, 2018).

• Rape culture: Zaleski (2015) states that in cultures that are predominately male, sexual assault is historically prominent and the domination and objectification of women is often endorsed. Comparative to college campuses, the military is a hypermasculine environment where the possibility of sexual assault is almost expected Zaleski (2015). In 2013 Donald Trump stated, “26,000 unreported sexual assaults [sic] in the military-only 238 convictions. What did these geniuses expect when they put men & women together?” (Diaz, 2016). This statement

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• suggests that there is a level of rape myth acceptance because females serve in a male-dominated military.

• Service member: An individual who has been indoctrinated and is currently serving in the military (UCMJ, 2010).

• Sexism: According to Merriam-Webster, sexism consists of discriminatory behavior, conditions, or attitudes, that are often directed against women, and foster stereotypes of social roles based on sex (2019b).

• Uniform Code of Military Justice (UCMJ): The UCMJ is a separate legal framework that governs all military personnel, and it must be adhered to throughout one’s commission or enlistment. The service member is held accountable under all laws, including the Uniform Code of Military Justice (UCMJ, 2010).

• Unacknowledged rape: When a person experiences an event that meets a legal or empirical definition of rape, but he or she does not label it as such (Newins et al., 2018).

• Veteran: A person who served on active duty in the military and was discharged or released under conditions other than dishonorable (USC 101; USC 920, 2019).

Statement of Assumptions

The following list of assumptions are drawn from clinical and theoretical research:

• Through intense interaction and dialogue both the participant and the researcher will experience a deeper insight into the lived experience of the long-term effects of MST.

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• MST is a unique form of adult-onset trauma, with all-encompassing psychological and medical consequences, that is experienced by the survivor as both a personal and institutional betrayal. The complexities of MST have not been discussed within a wide range of psychoanalytic theories.

• A common myth is that MST is prevalent because women are serving in combat areas, and this is not true. MST can occur anytime, in any part of the world, and during any war and during a time of peace for both men and women.

• The rate of occurrence of MST against female service members is considerably higher than it is for men in the male-dominated military structure.

• The high occurrence of MST is an indication that the military facilitates an environment and infrastructure where perpetrators continue to violate and hide.

• Service members who chose not to report their MST incident because of personal, social, and professional reasons.

• The effects of MST is an invisible wound that often goes unnoticed and untreated and is not treated with the same level of respect as wounds that have resulted from combat.

• MST survivors struggle to maintain a positive sense of self and are constantly on guard against the culture of misogyny which is prevalent throughout the military, and against the rejection and betrayal from the institution that they chose as a symbol of strength and protection.

• MST affects the survivor intrapsychically and interpersonally.

• Understanding the longitudinal negative effects of MST, and the sexual objectification beliefs and behaviors that are interwoven within the military

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system, through a self-psychology lens may improve therapeutic efforts as this information is integrated into the clinical work with women survivors.

Epistemological Foundation of the Project

The epistemological interchange between the participants’ lived experiences and analysis of the data allows for an in-depth exploration that is both flexible and accurate as possible. In order to allow such exploration, one that is flexible and accurate for this study, a phenomenological qualitative design methodology will be utilized. Qualitative methods are a broad class of empirical procedures designed to describe and interpret the experiences of research participants in a context-specific setting (Denzin & Lincoln, 2000; Ponterotto, 2005).

Since qualitative methods focus on the experience of research participants in a context-specific setting, qualitative methods are appropriate for the current study of the lived experiences of women survivors of MST. The military is a context-specific setting that plays a prominent role in how women who have experienced MST continue to relive their trauma long after they leave the military (Morris, 1996). Phenomenological qualitative approach fosters a constructivism epistemology, which is concerned with the relationship between the “knower” (the research participant) and the “would-be knower” (the researcher; Ponterotto, 2005). The constructivist recognizes that the researchers’ own personal background impacts and helps shape their interpretations of the data gathered during the interviews (Creswell, 2008).

Constructivism entails the social construction of reality (Morrow, 2005). The constructivists consider the extent to which participants are profoundly understood, and

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there is a mutual construction of meaning between the researcher and participant (Morrow, 2005; Ponterotto, 2005). Individuals develop subjective meaning of their lived experiences (Creswell, 2014). Meaning, individuals seek to understand the world in which they live, work, and exist.

Epistemology is defined as “theories of knowledge that justify the knowledgebuilding process that is actively or consciously adopted by the research” (Gringeri et al., 2013, p. 55). The epistemology chosen for this study is constructivism because I will be examining real-world phenomena through critical awareness of the participants’ lived experiences. These processes are imperative for reinforcing the validity of the study.

Constructivist epistemology considers the researcher’s emotional and expectant stance significantly. The researcher is required to acknowledge, describe, and “bracket” his or her values, but not eliminate them (Morrow, 2004; Ponterotto, 2005, p. 131).

Foregrounding

Utilizing IPA for this study is appropriate because it will be used to explore the lived experiences of female survivors of MST, as well as the effects on them as they continue to age. From a hermeneutical frame of IPA, this study will try “to make sense of the participant who is trying to make sense of what is happening to them” (Smith et al.2009).

My clinical career began in 1992, at a juvenile detention and prison facility in Guam, where I worked with serious and non-serious offenders. I also ran a transitional home at the same institution which housed non-offenders who were homeless. After returning to

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the mainland in 1994, I worked as a mobile emergency psychiatric therapist for the State of Arizona, and as an investigator for Child and Family Services.

I returned to Illinois in 1999 and became employed as a therapist for a specialized foster care program, and then I subsequently became a director for the same agency. In 2003, I was the clinical director of a homeless women and family’s program. Since 2005, I have worked for the federal government. Initially, I worked within the Department of Defense (DoD), collecting psychological data on military recruits with an emphasis on the determination of their suitability for continued Naval service or specific fitness for duty. I also conducted interviews with referred recruit personnel and provided speculations on differential diagnoses.

As an employee for the Department of Veterans Affairs Hospital Administration (VHA), Readjustment Counseling Service (RCS), beginning in 2007, I became a trauma therapist and treated those who served in combat or experienced MST. In 2013, I became the site director. For over fourteen years, I have specialized in identifying, assessing, and treating combat veterans, and both male and female survivors of MST. Recently, I started a private therapy practice on the south side of Chicago.

Throughout my diverse clinical work experiences, and my years of treating militaryrelated trauma, my understanding, and curiosity of the long-term and wide-range psychological and physiological effects of MST on survivors continues to evolve. My understanding and curiosity extend to my astonishment of the substantial number of MST survivors that I have encountered who are unidentified as survivors and are underdiagnosed for the trauma they experienced. The unidentified and underdiagnosed survivors are not aware of the broad spectrum of clinical and medical services that are

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available to them. Further, they are often uninformed about the federal and state benefits that they are potentially eligible to receive. More importantly, they are frequently oblivious to the sequelae of medical and mental health challenges, as well as the relationship between MST and suicidal thoughts and behaviors that are directly related to their military trauma.

In addition, I was inspired to view the effect of MST through a psychodynamic lens by a dissertation by Davis (2016) that explored the correlation between “being broken” and combat soldiers experiencing suicidal ideations of soldiers. She also investigated how combat soldiers are affected intrapsychically and interpersonally by their war trauma and their military experience. Davis (2016) grounded her research on the effects of combat trauma in the prominent psychoanalytic literatures of Freud (1920), Kardiner (1941), Fairbairn (1952), Kohut (1971), Ornstein (1994), Stolorow (2007, 2002), and Wolf (1995) to name just a few. The psychoanalytic direction Davis (2016) chose to explore for her research on combat veterans intrigued me. I was intrigued because the psychological and psychophysiological effects endured by combat veterans identified in Davis’ (2016) research, have been identified by VA researcher, Bell (2011), and the Management of Posttraumatic Stress Disorder Work Group (2017), as being the same effects experienced by MST survivors. Bell (2011) has conducted in-depth research on MST and how survivor’s reactions are shaped by various aspects of the military context.

For all of the above reasons, this study will formally explore female MST survivors who have internalized their trauma. I will focus on the lived experience and perspectives of a small sample of survivors. Because a phenomenological approach offers a more comprehensive way of obtaining the lived experience of female survivors, who endured

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MST, this research study’s aim will be to gain a rich and in-depth understanding of the essence of the survivors’ subjective experiences.

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Chapter II

Literature Review

Introduction

The United States military accepts young people from across the nation to defend its interest against armed threats and perform humanitarian work. The military reflects American society, and every attribute and challenge that exists in society also exists in the military, including sexual misconduct. Just as in society, women are objectified and subjected to sexual harassment and sexual assault in the military. In every military branch, women endure MST by their superiors and peers. The crime of MST occurs where women work, live, and socialize. Based only on the number of women who reported their MST crime, because most do not report, it is estimated that women are sexually assaulted in the military every 55 minutes (YWCA, 2017). As a consequence of MST, women survivors suffer a plethora of mental, emotional, physical, relational, and occupational challenges, including suicidality (Monteith et al., 2019).

The aim of this study is to build on and understand MST through a psychodynamic lens. Although there are a multitude of studies that have attempted to understand the psychological and emotional impact of MST (Monteith et al., 2019), very few have focused on the lived experience of female survivors and the ongoing effects as they continue to age. Further, there are no psychodynamic studies found on MST. In an

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attempt to gain a broader knowledge on this topic, this qualitative study will explore the lived experiences of such MST survivors, and the data will be analyzed through a psychodynamic lens.

For this literature review, much attention was placed on past research on the experiences of MST survivors by considering how MST finally came to the world’s attention, followed by how military sexual assault and harassment are legally defined and the challenges of reporting MST crimes while still serving in the military. This review also explains how women survivors have been devastated by the interpersonal and institutional betrayal of MST, that a rape subculture exists within military culture, and how survivors have been retaliated against for reporting their MST crime. Finally, this literature review will discuss the short and long-term effects of MST and examine the interpersonal and intrapsychic experiences of women MST survivors.

Examining survivors’ lived experiences makes sense because the lasting effects of MST cannot be seen and often goes unnoticed (Andersen et al., 2019; Gibson, et al., 2016; Reinhardt et al.). The invisible, untreated wounds dramatically affect the lives of the female survivors and their loved ones, according to the USC and HCVA, Subcommittee on Disability Assistance, and Memorial Affairs (2012). Anecdotal evidence suggests the medical professionals tend to neglect to assess for a history of MST and symptoms directly related to possible MST. This oversight significantly impacts the therapeutic process and hinders the patient’s personal and emotional wellbeing and growth. Even with everything that is known about the devastating effects of MST on female survivors, it continues to exist in the military (USC & HCVA, 2012).

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The experiences of military women seem to be inextricably linked to incidents of MST, and there is evidence that suggests MST is deeply embedded in military culture (Lofgreen et al., 2017; Wolff & Mill, 2016). Regardless of the numerous contributions women have made while serving in the military, they often are objectified and subjected to sexual harassment and even sexual assault in their work and living space (Castro, 2013, Murdoch et al., 2006; Zaleski, 2015). According to Sadler et al. (2004), women serving in the military have historically been repeatedly exposed to harassment and violence by their superiors and fellow members. Repeated violence exposure is a common occurrence in the military, including physical assault and rape (2004). Several highly publicized reports of sexual misconduct in the military indicate that sexual assault and harassment against military women have reached epidemic proportions (Murdoch, 2006; Zaleski, 2015).

How MST Finally Came to the Public’s Attention and Its Continued Existence

Women have a long history of unofficially serving in the military and have proven themselves during times of both peace and war and honorably performing various functions, ever since this nation has been in existence (Castro, 2013; Murdoch et al., 2006). However, it was not until 1942 that women were legally and officially allowed to join and serve in the military as nurses and clerks (2013; 2006). Currently, women successfully serve in the military in almost every capacity, including in some combat situations (Aponte et al., 2017). Over 40,000 women were deployed in support of the Persian Gulf Conflict during the summer of 1990 until mid-1991 (Aponte et al., 2017; Yaki et al., 2013). The Persian Gulf deployment was a historical time for the military

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because it would be the first-time women would serve in combat roles (e.g., fighter pilots, fuel truck drivers), and some became POWs (Aponte et al., 2017; Yaki et al., 2013).

In the same year as the Persian Gulf Conflict, that saw the historical change in the role of women in the military, the pervasive nature of MST was exposed. Late into 1991, the Tailhook scandal introduced the term MST to the nation (Lancaster, 1993; Yaki et al., 2013). The Tailhook scandal’s highly publicized coverage brought the world’s attention to the pervasive nature of sexual misconduct in the military (Cernak, 2015; Morral et al., 2014; Turchek & Wilson, 2009). The Tailhook scandal involved 140 Navy and Marine aviation officers being accused of sexually assaulting and harassing 97 service members, both men and women, during their 35th annual aviation conference in Las Vegas (Lancaster, 1993; Yaki et al., 2013).

Based on the testimonies of the perpetrators, these incidents were not isolated events that only occurred during the conference; sexual assault and harassment also occurred at previous conferences and during overseas deployments (Lancaster, 1993). The Pentagon’s inspector general’s report included statements from some of the officers who described the regular occurrence of adultery, drunkenness, and indecent exposure, which would take place during previous conferences and deployments (1993). The officers believed that their behavior during the 1991 conference was acceptable because they considered themselves to be returning heroes (1993). It was also reported that the officers prowled the halls with their genitals exposed and others wearing T-shirts with the slogan, “Women Are Property” (1993). The investigators also found that 33 navy admirals and two marine generals attended the conference, which meant that the leadership either participated in this behavior or did not stop it (1993). What made the 35th Annual

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Tailhook Conference different from previous years was that the incidents happened to some of the women who were also war heroes (Lancaster, 1993; Yaki et al., 2013).

The response to the Tailhook incident involved establishing a variety of policies and mandates to curtail the recurrence of MST and the provision of mental and clinical services for military members and veterans. The Navy and Senate Armed Forces Committee outlined and enacted a “zero-tolerance” policy against sexual misconduct defined as MST (Cernak, 2015). In 1992, a congressional mandate urged the VA to treat, at its facilities, the emotional and physical sequelae of MST endured by survivors during their military service (Burgess et al., 2016; Lofgreen et al., 2017). This led to the Veterans Hospital Administration (VHA) MST directive 1115 (1992) that details the policy on clinical care, monitoring, staff education, and outreach related to MST counseling, care, and services. This directive also defines the eligibility criteria for VA services, which includes sexual trauma experiences that occur during either active or inactive duty training (VHA MST Directive 1115).

In an effort to further ensure that these mandates and policies are upheld, DoD established the Sexual Assault Prevention and Response Office (SAPRO) in 2005 (DoD SAPR, 2020; Wolff et al., 2016), approximately 13 years after the Tailhook scandal. In the intervening 13 years, women continued to be violated during peacetime and while serving in multiple war conflicts. SAPRO is responsible for deploying mental health providers, nurses, and chaplains to improve access to quality mental healthcare for sexual assault victims in deployed environments (Castro et al., 2013).

At this juncture, it is important to mention that the DoD recognized the negative attitude and sexual violence towards women in the military mirrored what was occurring

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in the civilian community. In 2005, the military embraced VAWA, the federal Violence Against Women Act (Chu, 2008; National Center on Domestic and Sexual Violence [NCDSV], 2005), which Congress initially passed in 1994 in response to the high number and severity of violent crimes committed against civilian women (i.e., domestic violence, dating violence, sexual assault, and stalking; VAWA, 1994). The VAWA was passed just two years after the Tailhook scandal. However, it was not until 2005, when the legislation needed reauthorization, that the DoD suggested that VAWA include enhanced services for military survivors of domestic and sexual violence (NCDSV, 2005).

To determine which enhanced services to provide, the DoD established a commission to appoint military leaders and civilian experts to implement the recommendations from past and present task forces on domestic violence and sexual assault, including the provision of confidential services for survivors (NCDSV, 2005). The commission would be tasked with ensuring the collaboration between civilian authorities and military installations and facilitating the coordination between the DoD and other federal agencies addressing violence against women (NCDSV, 2005; United States Congress and House Committee on Veterans’ Affairs, 20102010). The commission would also be responsible for developing strategies for increasing community collaboration to enhance victim safety and services and to promote offender accountability (2005;10).

However, the attempt to incorporate the military within the VAWA (2005) legislation was unsuccessful. Instead, the military established the SAPR Program during the same year to address the MST epidemic (Chu, 2007; DoD SAPRO, 2005; USC & HCVA, 2010). Since then, the SAPR Program continues to exist and has been revamped

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multiple times. The SAPR Program will be discussed later in this chapter.

On the civilian side, VAWA expired in 2019, but it may yet play a role in the military response to MST. Even though VAWA was not reauthorized, currently there is proposed legislation, the National Defense Authorization Act (NDAA) 2021, that would essentially be a reauthorization of the VAWA but would also include the military. The NDAA would create a system of military protective orders that would allow military judges and magistrates to issue protective orders that would comply with VAWA (NDAA, 2020). This system did not previously exist, and the current military protective orders are not recognized by civilian law enforcement (2020). If military protective orders are recognized by civilian law enforcement, victims can gain greater protection (2020). Even though military members are required to adhere to all protective orders, military and civilian, in practice, it was ambiguous and inconsistent when it came to cases of domestic violence and MST (2020). NDAA would eliminate that confusion or inconsistency (2020). Currently, this topic is still being debated and the military was not mentioned in the recent reauthorization of VAWA (VAWA, 2021).

In addition to creating the SAPR Program, the military’s response to the Tailhook incident included establishing an academic program to improve the services that would be provided to victims of MST and the creation of an office that would oversee and coordinate the SAPR Program (DoD, 2020, 2019,162019, 2016). In 2006, the DoD established the Center for Deployment Psychology at the Services University of the Health Sciences. The Center offers behavioral health training for professionals who provide mental health services to military personnel (Castro et al., 2013). The DoD also established the Office of the Assistant Secretary of DHA in 2009 which in turn created

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the Health Affairs Sexual Assault Integrated Product Team to facilitate effective and efficient coordination of sexual assault response in the DoD medical community (2013). These efforts demonstrate the fact that the military has devoted significant resources toward creating programs that would address MST, but the problem of MST continues (Wentling, 2021).

Even though Tailhook may have introduced the term MST to the nation and recognized the seriousness of the offense, the DoD’s efforts have been largely unsuccessful in putting an end to it (Lohman, 2015; Mead, 2019; USC & HCVA, 2012). MST continues to occur and continues to be revealed intermittently up to the present day.

In other words, Tailhook may have introduced us to the magnitude and severity of MST, but MST continues unabated 29 years later with periodic reports of additional alarming incidents of MST. What follows are a few, among many, cases that have received significant attention in the media.

In 1996, at the Aberdeen Proving Ground, adjacent to Aberdeen, Maryland, an Army officer, and several male enlisted members were charged and subsequently prosecuted for sexually abusing fellow female service members (Cernak, 2015; Morral et al., 2014; Turchek & Wilson, 20092009). The perpetrators were charged with rape, physical assault, and communicating threats to the survivors if they reported the misconduct (Cernak, 2015; Morral et al., 2014). Also in the same year, three male noncommissioned officers were under investigation for sexual misconduct against female recruits in basic training at Fort Leonard Wood, Missouri (GAIA, 2016; Morral et al., 2014). The investigation also resulted in the perpetrators eventually being prosecuted. Almost ten years later, an investigation and subsequent prosecution resulted in several enlisted

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training sergeants admitting to sexually abusing female recruits during basic training, from 2005 to 2007, in Fort Leonard Wood, Missouri (Military Times, 2013). Also in 1996, a female sergeant reported the Sergeant Major of the Army for sexual assault (Carpenter, 2014). After her superiors at the Pentagon told her to resolve her issues with the Sergeant Major, she chose to retire (Carpenter, 2014; Hillman, 2014). The following year, the retired sergeant and five other women filed a formal complaint with the Army (Carpenter, 2014; Hillman, 1999; Jackson, 1998). The complaint detailed MST allegations regarding the Sergeant Major of the Army. The Sergeant Major was found innocent of all charges except one count of obstructing justice because he told a witness to lie to investigators (2014; 1999; 1998).

In addition to the frequent occurrence of MST within every military branch in the last 29 years since the establishment of the post-Tailhook MST preventative policies and directives, the continuation and severity of these crimes indicate that the military has a history of going through extraordinary measures to conceal some of the incidents. The cases of Lavena Johnson and Vanessa Guillen suggest that extraordinary measures were taken to conceal some aspects of their cases. In 2005, Sergeant Lavena Johnson was found dead on a military base in Afghanistan. Her death was ruled as a suicide (Blum, 2016; Martin, 2008; Watkins, 2020). According to the Army, Sergeant Johnson first poured acid on her genitals and then set herself on fire (Blum, 2016). Afterward, she reportedly shot herself in the mouth with her M16 (Blum, 2016; Martin, 2008; Watkins, 2020). Although the Army recommended a closed casket funeral, the family demanded that they see the body and that a second autopsy be performed (Martin, 2008; Watkins,

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2020). The second autopsy found significant discrepancies to the Army’s official report of suicide (Blum, 2016; Martin, 2008; Watkins, 2020).

The second autopsy found that Johnson had been shot on the left side of her head with a smaller caliber 9mm bullet (e.g., handgun) and not an M16 rifle, and her face was severely beaten (Blum, 2016; Martin, 2008; Watkins, 2020). According to the father, who is also a medical doctor, the story about Sergeant Johnson committing suicide with her M16 was unlikely because of her short stature and the length of her M16 (2020;08162008; 2016). The autopsy also revealed that parts of Johnson’s tongue, vagina, and anus were removed before the family received her body (Blum, 2016; Dawn, 2014). The military’s report does not indicate that the body parts were removed, and the family was not informed about the removal (Dawn, 2014). The second autopsy report also revealed that Johnson’s neck and nose had been broken; this was not mentioned in the Army’s report (2014).

During April 2020, Vanessa Guillen’s family reported her missing shortly after revealing to them that she was being sexually harassed by another soldier at Fort Hood, Texas (Alonso, 2020; Andone, 2020). Initially, the family reported her missing to the military; however, it was not until July when they hired an attorney and went to the media that Vanessa’s remains were found (Alonso, 2020; Andone, 2020). Vanessa was killed and dismembered at her place of work by the soldier whom she told her family was harassing her (Alonso, 2020; Andone, 2020; Cox, 2020). Vanessa’s tragedy became major national news and resulted in another federal investigation and the removal of the base commander (Cox, 2020). Further, there have been multiple investigations at Fort

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Hood in 2020 involving other sexual misconduct incidents and murder (Alonso, 2020; Andone, 2020).

In addition to the continued violation and objectification of women in the military, there are a multitude of cases involving superiors in trusted positions who have been some of the most deviant perpetrators of MST. In 2007, 12 drill sergeants and a training instructor were convicted of sexual misconduct at Fort Leonard Wood, Missouri (Bogan, 2015; Morral et al., 2014). In 2008, an investigation at the Lackland Air Force Base identified 38 female training recruits who reported experiencing MST by two training sergeants (United States Congress and Committee on Armed Services, 2013). In 2013, a sergeant who was responsible for sexual assault prevention at Fort Hood, Texas, was prosecuted for forcing a lower-ranking female soldier into prostitution and sexually assaulting two others (National Sexual Violence Resource Center [NSVRC], 2013). The same year, an Air Force lieutenant colonel, who was in charge of the sexual assault prevention program in Arlington, Virginia, was prosecuted for sexual misconduct (NSVRCNSVRC, 2013). In 2014, an Army sergeant was charged and later prosecuted for sexual misconduct against eight lower-ranking female soldiers (Bogan, 542015, 2014).

The SAPR Program Fiscal Year 2020 Report found that the rates of sexual assault reports increased by 17% and sexual harassment by 10% in 2018. The SAPR Report (2020) also pointed out that there was a higher number of reports by the Marine Corp than the other branches, followed by the Navy and the Army. The report also suggests that sexual harassment increased by 10%. The annual SAPR Report (2020) further indicates that, excluding Coast Guards, only 30% of the Armed Forces, reported their MST incidents. The Coast Guards were not included in the annual report.

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The multiple incidents listed above are just a few of thousands of allegations throughout the years since the Tailhook investigation. Anecdotal evidence suggests that once the Tailhook scandal became public, survivors of MST believed that sexual assault and harassment would have stopped (personal communications). However, the continuation and severity of MST cases since the Tailhook investigation is an indication that MST is not only pervasive but an epidemic. Therefore, this raises the question, “why does MST continue to happen?” However, before attempting to answer this question, it is necessary to discuss how MST is defined.

The Definition of Military Sexual Assault and Harassment

This discussion will first explain how the DoD’s UCMJ defines MST to provide an important, grounding definition. Providing a grounding definition is not only necessary in identifying what MST is, but also to distinguish between the different characteristics of MST that have been used to describe it. This provides significant clarification as some literature only defines sexual assault in the military, avoiding any discussions of sexual harassment. Essentially, definitions may be selective concerning what qualifies as MST and may not include a full range of behaviors. Not providing a comprehensive definition is consequential. It is essential to include both sexual assault and harassment in the definition of MST to understand how survivors are affected by their experience fully and long-term (Lohman, 2017). On an anecdotal level, not including sexual harassment in the definition of MST limits the services survivors can qualify to receive through the VA. Further research is required regarding the history of the partial definition of MST and how the level and provision of services to the survivor have been limited as a result.

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The most comprehensive definition and classification of MST fall under the DoD, UCMJ, USC, and VA. This definition is comprehensive because it references both sexual assault and harassment. MST is classified as a major, violent, criminal sexual offense against current military members, entailing sexual assault as intentional sexual contact characterized by the use of force, threats, intimidation/harassment, or abuse of authority, or when the victim does not or cannot consent (USC 1720D; USC 920, 2019). According to the UCMJ and the VA, both men and women can be targeted. Perpetrators can be peers, superiors, men, or women (USC 1720D; 2019). MST often occurs where military members live and work (USC 1720D; 2019).

A more detailed definition for military sexual harassment is found in the USC Title 10, Section 1561 (2020). USC Title 10, Section 1561 (2020) defines sexual harassment as behavior that involves unwanted sexual touching, requests for sexual favors, and deliberate or repeated offensive comments or gestures of a sexual nature towards a military member or DoD civilian employee by a supervisor or person in a position of power, or a person of equal rank or status.

The DoD has established two departments for reporting sexual assault, SAPR and sexual harassment Military Equal Opportunity (MEO; Lofgreen et al., 2017). According to the parameters that the SAPR has established, service members may choose to report their sexual assault incident as restricted (i.e., confidential) or unrestricted (i.e., investigated; SAPR, 2020). A restricted report means that the survivors may choose to confidentially disclose their sexual assault incident without starting an official investigation (Burgess et al., 2013).

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Choosing to file a restricted report reduces the likelihood of the alleged perpetrators finding out that the survivors reported their incident (DoD SAPR, 2020). A restricted report enables the survivors to receive clinical and medical services to address their MST and possibly allow them to transfer to or work at a different location (2020). Restricted reports also protect survivors from potential retaliatory actions by the perpetrators or their command (i.e., organization; DoD SAPR, 2020; Christenson, 2014). However, there are some limitations to a restricted report. The limitations include survivors not being able to receive a Military Protective Order (MPO) or be reassigned for safety reasons, perpetrators may continue to have contact with the survivors, the crime scene evidence can potentially become lost, and survivors are limited to only a few specified individuals with whom they may discuss the incident (CNIC, 2020).

Essentially, it is safer for a member to file a restricted report because they are less susceptible to retaliatory behavior (CNIC, 2020). According to SAPR, restricted reports increased by 17% in 2019. The increase of restricted reports indicates the survivors’ concern about potential retaliatory actions by their perpetrators or organization (DoD SAPR, 2020). In 2019, 3,716 restricted reports were investigated, and 63% of them (or 2,339 cases) were recommended for higher action (2020). Of those recommended to the commanding officers for higher action, only 1,629 were seriously considered. The actions included 794 court-martials, 360 non-judicial punishments, and 474 adverse administrative actions, including involuntary discharge from the service (2020). Nonjudicial punishments and administrative actions are considered relatively minor disciplinary actions. In 2018, approximately 20,500 service members experienced sexual

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assault, comprising 6.2% of female service members and 0.7% of male service members (MSW@USC Staff, 2019).

As mentioned earlier, sexual harassment reporting falls under the purview of MEO and is reported separately from sexual assault. Sexual harassment and sexual assault continue to be reported separately, even though the DoD has admitted, since 2014, that both run along a continuum of harm of sexual offenses (DoD SAPRO, 2016; GonzálezPrats, 2017). This continuum occurs on a spectrum from gender-focused jokes, sexualized comments, and sexually offensive pictures to touching, groping, physical violence, forcible rape, and sodomy (González-Prats, 2017).

Sexual harassment is defined as illegal and is considered so severe or pervasive that a reasonable person would perceive the environment as hostile or offensive (DoD SAPR, 2020). Any individual in a supervisory or command role who uses or condones sexual behavior to control, influence, or affect the career, pay, or job of a military member or DoD civilian employee is engaging in sexual harassment (2020). A military member or DoD civilian employee who makes deliberate or repeated unwelcome sexualized verbal comments, non-verbal, or physical contact is engaging in sexual harassment (2020).

Sexual harassment complaints may be reported formally, informally, and anonymously (DoD SAPR, 2020). An informal complaint is defined as an allegation made orally or in writing and is not submitted as a formal complaint through the office designated to receive harassment complaints (2020). The allegation may be submitted to a person in a position of authority within or outside of the complainant’s organization. Informal complaints may be resolved at the lowest level through intervention by the firstline supervisor, alternative dispute resolution, informal mediation, or between the

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complainant and the alleged offender (2020). Anonymous complaints are also allegations, but they are received by a commanding officer or supervisor from an unknown or unidentified source alleging sexual harassment (2020). The complainant’s identity is not required to be divulged (2020).

A formal complaint is an allegation submitted in writing to the MDO office. An informal complaint may become formal if a commanding officer or a person in charge of the organization determines that it warrants an investigation (DoD SAPR, 2020). Both formal and informal complaints can either be substantiated, unsubstantiated, or pending. A substantiated complaint is a founded report for sexual harassment, and unsubstantiated is an unfounded allegation. A complaint that is pending is considered an open report that has not been resolved or adjudicated (2020). A complaint that is dismissed is a formal complaint that has been dropped to correct problematic behavior (2020). A dismissed complaint also occurs when there is more evidence to investigate another behavior or when a more severe problematic behavior requires investigation (2020).

The Challenges of Reporting MST Crimes

Disclosing sexual harassment and trauma, both formally and informally, are an integral part of the survivor’s recovery in the civilian community (Dardis et al., 2018). However, studies have shown that there are barriers and challenges to reporting MST in the military community, especially for women. Survivors tend not to report their MST incidents because retaliation is the norm (Baltrushes & Karnik, 2013; Cox, 2020; Protect Our Defenders, 2020; Wolff et al., 2015, 2016). Survivors fear retaliation from their command and coworkers, and they also distrust the legal process in the military (Dardis

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et al., 2016; Protect Our Defenders, 2020). Survivors also fear victimization by the perpetrators and their peers, resulting in losing their military career, receiving an unfavorable discharge, and having concerns about personal safety (Wolff & Mills, 2016).

There are other challenges that prevent female survivors from reporting their MST incidents. Those reasons include concerns that reporting would negatively impact their military career, that nothing would be done and business would carry on as usual, that there would be a lack of confidentiality, and that they blame themselves for the incident (Dardis et al., 2018; Mengeling et al., 2014). Mengeling et al. (2014) found that women officers were less likely to report their MST crime compared to enlisted women. However, Mengeling et al. (2014) do not specify why women officers reported less; general explanations of why female members in the military report less were provided. Service members are concerned about the lack of confidentiality, the adverse treatment by peers, and the possibility that nothing would be done (2014). Even though Mengeling et al. (2014) did not provide reasons why officers reported less, anecdotal evidence suggests that women officers may be less likely to report their MST because of the fear of losing their leadership position and the loss of respect from superiors, peers, and subordinates.

The barriers and fears of retaliation have led to a lack of trust in military reporting and legal systems. According to Wolff and Mills (2016), women could lose their security clearance and military career. They could also be physically assaulted or even killed for reporting their MST crimes (2016). As a result of these barriers, fears, and the limited options for reporting MST, service women do not trust the military legal system (Dardis et al., 2016; Farris et al., 2021; Protect Our Defenders, 2020; Webb, 2021). This is

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especially true when the perpetrator is in the survivor’s chain of command. This lack of trust has contributed to the survivor’s dissatisfaction and disillusionment with the military overall (Dardis et al., 2016; Protect Our Defenders, 2020).

Reportedly, 66% of military members who experienced retaliation after filing a sexual assault complaint were women, and 73% of these reports alleged that those who retaliated against them were in the survivors’ chain of command (Protect Our Defenders, 2020). Further, a study has recently found that several MST survivors have been retaliated against even though they chose to remain silent about the crime that was perpetrated against them (Farris et al., 2021).

Studies have also found that a third of the survivors are discharged from the military within seven months after reporting their MST incident (Protect Our Defenders, 2020). The crime of MST often occurs where survivors live and work, and they have been retaliated against by the same military institution that they swore allegiance to (Dardis et al., 2016; Kime, 2021; Smith & Freyd, 2014). In essence, this is a betrayal that is both interpersonal and institutional because of the actual crime perpetrated upon service members by their leaders and peers and the retaliatory actions taken by the command and coworkers (Dardis et al., 2016; Smith & Freyd, 2014).

As a result of this betrayal, the majority of women survivors do not report their MST crimes to formal authorities (Holliday & Monteith, 2019). Furthermore, women veterans do not immediately seek the support and medical services from the VA to address their MST experiences. Holliday and Monteith (2019) focused their research on determining why more women choose to forgo or delay utilizing the VA’s free medical and mental health care for MST-related health conditions. Their research reveals how MST survivors

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experience a sense of betrayal from the military due to the institutional response to MST or their perceptions that the institution failed to prevent their MST crime from occurring (2019). This sense of betrayal is extended to the VA Health and Benefits institutions, which provides an array of medical and clinical services to veterans and military personnel (Holliday & Monteith, 2019; Williams, 2020).

According to Holliday and Monteith (2019), the VA also presents as a perpetrator of betrayal for survivors because the VA is reminiscent of the military. For many MST survivors, the VA is potentially capable of betraying them in the same manner that the military did (e.g., invalidation of the incident, taking a “business as usual attitude,” disbelief, shaming, and blaming the survivor). This has even included assaulting women in a VA facility (2019). An example of how the VA has, at times, mirrored the Armed Forces is the recent scandal involving Robert Wilkie, the former VA Secretary (Kime, 2020). Wilkie was recently asked to resign from his leadership position after the VA Officer of the Inspector General found that Wilkie attempted to discredit a veteran who reported being sexually assaulted at a VA Medical Center in Washington, D.C., in 2019 (2020).

Military Culture and the Rape Subculture

As shown in the previous section, the military has historically responded to the political outrage of some of the most public MST cases. In response, oversight committees and studies were commissioned, programs have been developed to address the pervasiveness of MST, and annual reviews and reports are completed to determine the programs’ success and the status of military sexual misconduct. Service members are

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even asked to complete surveys to anonymously report sexual assaults on even-numbered years (Castro et al., 2013; DoD SAPR, 202, 202; Lofgreen et al., 2017)). Nevertheless, the toxic and harassing military culture continues to set the stage for sexual violence towards women. Besides, military women continue to experience difficulty in reporting their MST incidents. These realities beg the question: Why does MST continue to exist, and why do most women choose not to report?

The fact that sexual harassment and assault are pervasive in the civilian society indicates that they are also prevalent in the military (Caldara, 2018; Mondragon, 2015; Stimson, 2013). It seems to be the case that sexual harassment and assault are also problematic in the civilian society, just as in the military (2018; 2015; 2013). Sexual assault is a prevalent problem, and sexual harassment is inescapable in the Armed Forces, as is the case on college campuses and corporate America (Lofgreen et al., 2017; Zaleski, 2015). Both in the civilian and military context, it can be said that MST is part of the culture. The military is a male-dominated well-established institution, and women represent only 16.5-20% of the total population (Cichowski et al., 2019; DVA DMDC, 2020). The military is also a microcosm of society (Peter, 2016). Similar to society, a culture of misogyny exists in the military (Carolla et al., 2018; Peter, 2016).

Misogynistic attitudes contribute to the hostile attitudes towards women in the military (Wolff & Mills, 2016) and rape myth acceptance (Carolla et al., 2018; Yapp & Quayle, 2018). The hypermasculine military culture emphasizes group behavior through inexplicit norms and attitudes towards masculinity and sexual behavior, which may encourage an environment more conducive to sexual violence against women (Lee, 2016; Morris, 1996; Rasmussen, 2016). Due to the misogynistic attitude and hypermasculine

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environment that exist in the military, the possibility of sexual assault is almost expected (Zaleski, 2015). When former president, Trump, was asked about the high number of sexual assaults in the military in 2013, he indicated that the assaults are expected when men and women are placed together (Diaz, 2016).

Both DoD and VA researchers have made significant strides in studying sexual misconduct in the military and have found cultural characteristics to be contributing risk factors (Stander, 2016). The cultural risk factors in the military include the members’ young age range, excessive use of alcohol, attitudes supportive of rape (2016), and masculine behavioral norms (Lee, 2016; Morris, 1996; Rasmussen, 2016). The military culture is supportive of sexual harassment, and service members are at higher risk of sexual assault. Women in the military who experience sexual harassment are three times higher at risk for sexual assault (DoD SAPR, 2020). Although men have a much lower risk of sexual assault compared to women service members, men who are sexually harassed are twelve times greater at risk of sexual assault in the military (DoD SAPR, 2020). In essence, there is a positive correlation between an unhealthy military culture where sexual harassment exists and the risk of sexual assault (DoD SAPR, 2020).

Based on the data from an anonymous bi-annual survey compiled by the DoD in 2018, 20,500 (13,000 women and 7,500 men) military members were sexually assaulted compared to 14,900 in 2016 (DoD MST Report, 2018). The increase in sexual assault in 2018 was primarily women between the ages of 17 to 24 (DoD MST Report, 2018). Compared to male service members who make up 83% of the military (Creative Commons, 2020), the VA found that 1 out of every 4 females has screened positively for experiencing some form of MST compared to 1 out of 3 males (Protect Our Defenders,

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2016). Moreover, the American College of Obstetricians and Gynecologists Women’s Health Care Physicians (2014) reports that females serving in the military experience increased rates of sexual assault during their military service.

As suggested earlier, MST is a prevalent problem because the military is a microcosm of society. Similar to society, a culture of misogyny and rape myth acceptance exists in the military. These beliefs contribute to the hostile attitudes towards women in the military (Wollf & Mills, 2016) and rape myth acceptance (Carolla et al., 2018; Yapp & Quayle, 2018). Misogyny is defined by Merriam-Webster (2020a) as the hatred of, aversion to, or prejudice against women. Campbell (1981) describes misogyny as the hatred of women, which is why men who maintain misogynistic beliefs have harassed, raped, and murdered women. Misogyny is identified as a core problem for the existence and continuation of MST in the military (Lee, 2016). According to Lee (2016), the military organization views anything that is not considered masculine with disdain and as a form of weakness. The military’s disdain for weakness resulted in a toxic and perverse brand of masculinity to be drilled into its members during basic and boot camp training to transform new recruits into unempathetic military members who are quick to action and violence (Boulanger, 2020; Shatan, 1989)

The idea of MST being prevalent is also based on violent and sexualized language about women that have been historically expressed by male service members, and images of sparsely clad women have been openly displayed in the military workplace (Venkatesan, 2017). Zaleski (2015) suggests that the military is a hypermasculine environment where the possibility of sexual assault is almost expected. Accordingly, rape myth acceptance is a false belief about male-on-female sexual violence which

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stereotypically focuses on cognitive distortions that manifest as attitudes that support rape; attitudes that facilitate the justification of sexual violence, often serving either to blame the victim or her clothing to vindicate the perpetrator, to minimize claims of rape, or to allude that only certain types of women are raped (Crall & Goodfriend, 2016; Lee, 2016; Lehner, 2018; Rosenthal & Korb, 20132013).

These studies suggest that the military culture encourages male members to have negative attitudes about female members. In a phenomenological study conducted by Brownstone et al. (2018), women survivors experienced sexual harassment as an everyday occurrence and have reluctantly learned to expect it in the military. This study also revealed that the survivors remained silent in order to maintain their military careers. Also, they experienced a sense of loss of relational trust and a loss of faith in the military, and some even forced themselves to remain involved with men to increase their ability to feel safe (2018).

The study results uncovered by Brownstone et al. (2018) are remarkably similar to what the Army’s Fort Hood Independent Review Committee concluded in their December 2020 investigative report (McCarthy et al., 2020). As a result of an initial investigation into Army Specialist Vanessa Guillen’s murder, coupled with several other crimes and deaths at Fort Hood, a more profound problem was revealed within the military system and leadership, and a more comprehensive review was commissioned (2020). A comprehensive review was conducted by the Army to determine whether the command climate and culture at Fort Hood and the surrounding military community reflect the Army’s values (i.e., safety, respect, inclusiveness and a commitment to diversity, and workplaces and communities free from sexual harassment and sexual

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assault; 2020). After a diverse committee panel interviewed 31,612 soldiers, 647 officers, local civic leaders, law enforcement personnel, and the district attorney office, multiple major flaws were found to exist within the entire DoD SAPR program and the Fort Hood criminal investigation command field office (2020). The review panel also found that Fort Hood was permissive of sexual harassment and sexual assault (2020). It was revealed that female soldiers tend to slip into survival mode once realizing that they are vulnerable to MST and preyed upon almost daily (Cox, 2020; McCarthy et al., 2020).

Litz (2014) explains that the military reinforces machismo and misogyny and trains service members to be tough, stoic, and to dehumanize the enemy in order to be able to annihilate them. Zaleski (2015) stresses that an aspect of the military culture promotes a rape subculture that often idealizes masculine values (e.g., strength, toughness, and restricted emotionality). Mondragon et al. (2015) explain how the same masculine values of the military, and the perception of being emotionally strong, are contributing factors to why many survivors choose not to report their MST incidents.

Short and Long-Term Effects of MST

As a consequence of MST, survivors may feel trivialized and worthless as a military member. MST is a dehumanizing and self-esteem shaking experience that can cause incapacitating conditions (Gonzalez-Pratz, 2020; Holiday & Monteith, 2019). MST can severely affect the emotional and physical wellbeing of the survivor and result in longterm psychological disturbances (Gerard et al., 2018; Management of Posttraumatic Stress Disorder Work Group, 2017; Rasmussen, 2016). Research strongly indicates that women veterans who have a history of MST have a higher rate of attempting and

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completing suicide (Gerard et al., 2018; González-Pratz, 2020; Kimerling, 2016; Rasmussen, 2016), compared to those who have not reported having a history of MST (Monteith et al., 2016).

In addition to research finding a high occurrence of homelessness amongst MST survivors, Burkhart, and Hogan (2015) found that this population experiences a high frequency of intimate partner violence, interpersonal relationship problems, emotional regulation challenges, and maintaining stable employment (Gonzalez-Pratz, 2020; Holiday & Monteith, 2019; Mondragon et al., 2015; Rasmussen, 2016). The VA and DoD jointly published The VA and DoD Clinical Practice Guideline for The Management of Posttraumatic Stress Disorder and Acute Stress Disorder, which suggests that MST survivors have an elevated risk of developing severe PTSD (Management of Posttraumatic Stress Disorder Work Group, 2017). Other psychological effects may involve dissociation, anxiety, depression, dissociation, detachment, and extreme mood swings (DePrince & Gleaves, 2007; Fred, 1996, 1946; Gonzalez-Pratz, 2020; Holiday & Monteith, 2019; Mondragon et al., 2015; Rasmussen, 2016; Smith & Freyd, 20132013). The physical symptoms include irritable bowel syndrome, chronic pelvic pain, musculoskeletal pain, and migraine headaches (DePrince & Ramussen, 2016; Fred, 1994, 1996; Gleaves, 2007; Smith & Freyd, 2013;).

There are comprehensive medical and mental health treatments available through the VA to address conditions caused by the effects of MST, but most women survivors are not aware. In conjunction with many survivors not being aware that they may receive treatment designed to address their MST experience, there are those reluctant to reveal that part of their life to a medical provider (Holiday & Monteith, 2015; Mondragon et al.,

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2019; Rasmussen, 20162016). Their reluctance is due to the shame and guilt they have internalized due to their MST experience (2019; 2015; 2016; 20162016). As a consequence, these survivors do not receive treatment for their MST-related symptoms and behaviors. Even women who received less than honorable discharges have been informed that they do not qualify for any medical or mental health services to address their MST by both the military and VA systems (Myers, 2020). On the contrary, they are eligible for MST-related services regardless of their discharge (Kimerling et al., 2007). However, National Guard and Reserve members and veterans are excluded from receiving VA Medical services if they have never served on active duty or for less than 20 years, until they apply and receive VA compensation benefits (VHA MST Directive 1115, 2018). Active duty status may include active duty training, temporary duty assignments, and deploying to a war zone. Furthermore, survivors may receive MSTrelated counseling services at Readjustment Counseling Service (RCS) Vet Centers without needing a referral and regardless of military discharge or duty status (2018). Although survivors may receive counseling to address their MST at a Vet Center, their MST-related medical needs will go unaddressed by VHA (Lofgreen et al., 2017). The inability to receive unconditional MST medical and mental health care is significant because MST is a crime perpetrated by superiors and fellow military members under the all-powerful umbrella of the Armed Forces, where honor and integrity are drilled into the brains of every member during the first weeks of initial training (Rasmussen, 2016; Reinhardt et al., 2016; Vantage Point, 2021). Military members can experience MST during their first few minutes of service to this country (Rasmussen, 2016; Reinhardt et al.). However, they may be denied full VA care to address their MST-related conditions

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if specific criteria have not been met (2016; 2016). This is not just significant but is a disservice and insult to those who served in the military, and this is a gap in services that the DoD and VA must reevaluate (US DVA,, 2020).

Anecdotal evidence suggests that the experience of interpersonal and military institutional betrayal caused by MST serving in the United States Armed Forces is a nontransactional relationship between the service members and the military. Further, the relationship is non-transactional because there is no direct personal gain for the selflessness of the members, and they must rely on one another and the military for their survival. The most personal gain members receive, other than wages and medical and job training, is to unconditionally serve in the military. A member’s unconditional service involves everything up to and including death, but not MST. Although the member’s commitment and relationship to the military are personal and unconditional, there is still a reasonable expectation for the military to keep all members safe from the occurrence of MST. Military members are aware of the possibility of being hurt or killed while serving in combat. However, there is no expectation of being sexually harassed or raped by a fellow service member or superior. MST is not foremost on one’s list of decisions to join the military.

Members are in a committed relationship with the military institution where MST is frequently perpetrated. MST is an interpersonal trauma that involves a betrayal by a trusted individual that can cause lasting physical and psychological harm to the survivor (DePrince & Gleaves, 2007; Fred, 1994, 1996; Lofgreen, 2017; Smith & Freyd, 2013).

The crime of MST continues to be committed against military members who have sworn their allegiance to this country, to defend the constitution, and to obey the

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president, and the orders of officers appointed over them is an institutional betrayal (Smith & Freyd, 2013). The concept of institutional betrayal occurs when people or an institution, which an individual depends upon for survival, violates the individual’s trust and wellbeing (Dardis, 2016; Rasmussen, 2016; Smith & Freyd, 2013). Institutional betrayal results in survivors experiencing victimization by the very institution they chose to join for the fulfillment of their selfobject needs (e.g., safety, mirroring, strength, validity, reassurance, and a structure to merge with; Kohut, 1971; Siegal, 1996). The military institution betrays its members by failing to protect them from the crime of MST. The military’s failure to prevent, address, and protect its members from MST results in the shattering and incomprehensible effects on survivors’ lives (Dardis et al., 2016; Rasmussen, 2016).

The effects of MST are shattering and incomprehensive because survivors are victimized as military members, which conflicts with the identity that they developed during their military training and service (Dardis et al., 2016). Military members are trained to be strong, tough, and physically powerful (2016). They are also trained to be stoic and mentally strong (Litz, 2014). The experience of MST thus shatters the survivors’ previously held assumptions of loyalty and strength about the military and themselves, which interfere with survivors’ ability and motivation to report their MST crime while serving in military settings (Dardis et al., 2016). Most recently, an Inspector General investigation conducted at the Fort Hood Army base determined that female soldiers tend to slip into survival mode once realizing that they are vulnerable to MST and preyed upon (Cox, 2020). Thus, female soldiers are fearful of reporting their MST crime which would most likely result in them being ostracized and revictimized (2020).

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The perpetuation of MST by a trusted peer or by a superior who is charged with the responsibility of guiding and protecting military members has been compared to secretive forms of violence and abuse that take place within a family (Lofgreen et al., 2017). The continued perturbation of MST of military members mirrors the molestation of children within a daycare or religious institutional setting (Lofgreen et al., 2017; Smith & Freyd, 2013). Similar to children, molested by those who have power and control over them, within an institutional setting, military members are under the power and control of their perpetrator and the military establishment (2017; 2013). As a result, MST survivors experience an intense sense of betrayal and the inability to trust anyone for support or protection (Lofgreen et al., 2017). The atmosphere of pervasive and inescapable MST, and the betrayal by the military institution, have caused survivors to experience feelings of powerlessness and patterns of learned helplessness as they continue to work and live with their perpetrators (2017). Further, MST is a profound dehumanization and unforgivable insult to any military member, which affects them on interpersonal and personal levels.

The Interpersonal and Intrapsychic Experiences of Women MST Survivors

As previously stated, there seems to be a lack of psychoanalytic literature on MST. However, there is a great deal of psychoanalytic literature found on the effects of war trauma and childhood sexual trauma. Reviewing psychoanalytic literature on the effects of war to understand how MST survivors are interpersonally and intrapsychically affected is relevant because the DoD and VA have acknowledged that the effects of MST are comparable to the effects of war trauma (Lofgreen et al., 2017; Management of

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Posttraumatic Stress Disorder Work Group, 2017; Smith & Freyd, 2013). The decision to focus on childhood sexual trauma literature for this study was influenced by Freyd’s (2008) betrayal trauma theory and Smith and Freyd’s (2013) theory on institutional betrayal trauma (Rasmussen, 2016). Freyd’s (2008) child sexual trauma theory stipulates that individuals who are sexually traumatized, by people or institutions on which they depend on for their survival, severely violate the individuals’ trust or wellbeing (Rasmussen, 2016). Smith and Freyd’s (2013) institutional betrayal trauma theory suggests that a subordinate, or weaker person, who is sexually traumatized is under the power and control of the perpetrator and institution (e.g., daycare centers, colleges, business organizations, religious institutions, and military establishments). Therefore, the comparisons between war and childhood molestation and MST are appropriate.

The key concept here is understanding why these comparisons of interpersonal and intrapsychic experiences are relevant in explaining the shattering and incomprehensible effects of MST on women survivors. But first, it is necessary to define the terms interpersonal and intrapsychic before discussing the psychoanalytic literature. Defining the meaning of interpersonal and intrapsychic is essential to thoroughly understand how women in the military have been affected by their MST experiences.

Interpersonal phenomena refer to processes occurring between people, starting with one’s family of origin, where relationship patterns originate (Lingiardi & McWilliams, 2017; Mitchell, 1988; Sullivan, 1940). It is concerned with how thoughts, feelings, and behaviors are externally influenced by others (Lingiardi & McWilliams, 2017; Mitchell, 1988). A person’s internal world (i.e., thoughts and feelings) is influenced by her

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interpersonal relationships and experiences, past and current, with other people (Lingiardi & McWilliams, 2017; Mitchell, 1988; Sullivan, 1940).

Intrapsychic phenomena occur within a person’s inner world (i.e., psychic reality); these are psychological processes and functions (Mitchell, 1988; Sullivan, 1940). The intrapsychic determines how an experience is understood on both preconscious and unconscious levels within the mind and body of the person through the use of perception and feeling (1988; 1940). According to Sullivan (1940), the intrapsychic experience is intrinsically interpersonal because it originates from one’s interactions occurring within the interpersonal field (Mitchell, 1988). The interpersonal field is everything within the mind that has been experienced through interpersonal relations with others (Mitchell, 1988; Sullivan, 1940). The interpersonal field is vital for emotional regulation, and it establishes patterns of integrating relationships with others which provide a sense of familiarity, safety, and control. This is important because previously established emotional regulation can be severely hampered when one encounters an adult-onset trauma, which can result in a traumatic memory being repeatedly re-experienced in the present, such as in flashbacks and nightmares (Davis, 2016; Ornstein, 1994; Stolorow, 2007). In essence, the interpersonal field increases the possibility of self-regulation and encompasses a person’s intrapsychic reality, which is continuously influenced by past and present interpersonal relations.

Now that the interpersonal and intrapsychic terms have been defined, the discussion can move on to explore some of the psychoanalytic literature that examines the interpersonal and intrapsychic effects of war and childhood sexual molestation, which are comparable to the effects of MST. In an effort to explore the commonalities of MST, war

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trauma, and childhood molestation, this section will first discuss Freud’s (1920) paper on traumatic neurosis and war neurosis followed by Ferenczi’s (1933) expanded theory of the same subject. In addition to Ferenczi’s (1933) expanded version of Freud’s (1920) neurosis theory, this section will also discuss Ferenczi’s (1933) theory on the effects of childhood sexual abuse. This section will next discuss some of the psychoanalytic writings of Nadelon and Notman (1979) regarding the response to rape, Boulanger’s (2007) discussion of adult-onset trauma, and Kohut’s (1971, 1977) theory of conscious and unconscious fulfillment of selfobjects to name just a few.

The term traumatic neurosis was first introduced by a German physician, Hermann Oppenheim, in 1884, and war neurosis [Kriegsneurose] was coined by the German physician, Honigman, in 1907 (Crocq, 2000). In his book, Beyond the Pleasure Principle, Freud (1920) sought to describe the debilitating effects of war on the soldier. Freud (1920) explained the condition caused by the mental reaction to external danger as war neurosis and traumatic neurosis. According to Freud (1920), war neurosis results from war or combat situations, and traumatic neurosis occurs during a time of peace or nonwar situations (e.g., catastrophic accidents or natural disasters). Even though one of these terms highlights the experiences of war, Freud (1920) uses these terms interchangeably to describe the effects of war or a catastrophic event.

As a consequence of war-related trauma, one experiences an inability to eliminate excessive excitations from the mind, which are psychosomatically experienced as different sensations in the body (Breuer & Freud, 1893-1895; Frankel, 1998). Traumatic neurosis, according to Freud (1920), emerges when surprise or fright is experienced. Also, according to Freud (1920), traumatic neurosis does not emerge when a wound or

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injury is inflicted simultaneously with surprise or fright. A subsequent theory shows that traumatic neurosis does actually emerge when a wound or injury is inflicted simultaneously with surprise or fright, but more on that insight is mentioned below.

Further, according to Freud (1920), the effects of the feelings of anxiety, fear, and fright continue to exist in survivors even when they are no longer in the war environment. The anxiety can be conceived as an anticipation of danger or impending doom caused by either known or unknown objects (Frankel, 1998; Freud, 1920). Fear results from the expectation of a known danger, and fright occurs as a complete surprise (Freud, 1920), often experienced in the war zone. The key point here is that the survivors of war trauma experience a traumatic neurosis that causes them to continue to suffer the devastating effects of their experiences many years afterward (Boulanger, 2007; Burgess et al., 2016; Clements et al., 2004; Ferenczi, 1932; Freud, 1920; Lofgreen et al., 2017; Management of Posttraumatic Stress Disorder Work Group, 2017).).

Ferenczi (1932) expanded upon Freud’s (1920) war neurosis theory, and he also theorized on the effects of childhood sexual abuse by a parent (Ferenczi, 1916, 1917; Frankel, 1998; Rachman, 2000). According to Ferenczi (1932), there are two types of war neurosis which are called by the same name (Frankel, 1998, 2017). Both are considered narcissistic reactions to trauma (Ferenczi, 1916, 1917; Frankel, 1998, 2017). The first type of war neurosis is a fixation or paralysis caused by an initial shock of the trauma resulting from extreme anxiety, which takes place in anticipation of the trauma, just before it occurs (Ferenczi, 1949; Frankel, 1998, 2017). Kardiner (1941), who treated WWI and WWII combat veterans, also saw this war neurosis in the veterans he treated. For Kardiner (1949), war neurosis equals fixations as an unconscious process of

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becoming emotionally numb. The emotional numbness allows the veteran to avoid becoming overwhelmed by unpleasant emotions when triggered (Davis, 2016; Kardiner, 1949).

The second type of war neurosis is considered more complex and results in a narcissistic injury after suffering an overwhelming shock or wound and causes an insult to one’s self-esteem or shatters one’s self-confidence (Ferenczi, 1916, 1917; Frankel, 1998, 2017). Associated symptoms of the second type of war neurosis include anxiety, hypersensitivity of the senses, to certain external stimuli, frequent re-experiencing the traumatic events, and nightmares and night terrors (Frankel, 1998, 2017).

It is important to emphasize that Ferenczi’s description of both types of war neuroses is helpful in explaining the effects of MST, sexual harassment, and sexual assault. Anecdotally speaking, the first type of war neurosis, described as being a fixation or paralysis caused by an initial shock or anticipation of the trauma resulting from extreme anxiety, is comparable to what is experienced as a result of sexual harassment; and the effects caused by the second type of war neurosis is similar to what is experience after a sexual assault.

Ferenczi’s years of research and observations of the effects of both types of trauma, war, and childhood sexual abuse, led to Ferenczi’s (1932) discovery of significant similarities between the two (Frankel, 1998; Rachman, 2000). Ferenczi (1932) found that the defense mechanisms used by the survivors of war trauma and childhood sexual abuse to help them cope with their experience are essentially the same (i.e., denial, detachment, and dissociation; Frankel, 1998; Rachman, 2000). He also observed that the effects of war-related trauma and childhood sexual abuse are registered in the survivor’s body

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(Bourke, 2012; Ferenczi, 1932; Frankel, 1998; Rachman, 2000). This is where Ferenczi corrects Freud’s (1920) war trauma theory on traumatic neurosis not emerging when a wound or injury is inflicted simultaneously with surprise or fright. According to Ferenczi (1932), traumatic impressions bypass the conscious mind of the defenseless person and are registered in the body at the moment of the traumatic event (Ferenczi, 1932; Frankel, 1998). Because of the terror that is experienced, the defenseless person is temporarily paralyzed and is therefore unable to resist the attack (Ferenczi, 1932; Frankel, 1998). Additionally, Wolf (1995) stated that a physical injury could cause a combat veteran to experience a psychic trauma, also referred to as an emotional wound or shock (Davis, 2016). A psychic trauma can result in lasting damages to the veteran’s psychological development, causing a neurosis (Davis, 2016; Wolf, 1995).

Ferenczi (1932) explains that a person’s response (i.e., a shock of temporary paralysis) to trauma is psychological, which becomes part of the person’s interpersonal world. This is because of the meaning that is attached to the traumatic event and the survivor’s adaptation to the event (Frankel, 1998, 2017; Rachman, 2000). Fundamentally, it is the survivor’s individualized adaptation to the traumatic event that influences the survivor’s subjective experience (1998, 2017;2000). Ferenczi (1949) states that the subjective experience of confusion, betrayal, depersonalization, shock, helplessness, emotional numbness, loss of consciousness, dissociation, and trauma develops when a child is sexually and emotionally seduced by a parent (1998, 2017; 2000), when a military member experiences war trauma, and when a woman suffers sexual harassment or assault in the military (Lofgreen et al., 2017; Management of Posttraumatic Stress Disorder Work Group, 2017; Smith & Freyd, 2013).

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Like Ferenczi (1932), Nadelon and Notman (1979) view sexual trauma as comparable to what is endured in war. Sexual trauma is the ultimate violation of the self that invades the inner and most private space of the survivor and causes a loss of autonomy and control (Nadelon & Notman, 1979). Therefore, the effects of MST can be considered a trauma similar to the psychological effects of what is experienced in war, genocide, or domestic violence (Boulanger, 2007). MST is an adult-onset interpersonal trauma caused by a catastrophic event (2007). MST is also a massive psychic trauma that can cause issues and lasting dynamic traumatic responses (Boulanger, 2007; Bourke, 2012; Clements et al., 2004), including ongoing fear, emotional instability, high-risk behavior, and dysfunctions within the survivor’s personal and social relationships, and PTSD (e.g., recurrent thoughts, intrusive visual and auditory hallucinations; Boulanger, 2007; Clements et al., 2004).

Ferenczi and others have made a compelling argument about how war trauma and sexual trauma cause similar interpersonal and intrapsychic effects. Ferenczi (1932) also discusses the issue of the differences in power and how those differences have a traumatic effect when a person suffers from sexual trauma committed by someone who has power over them. This interpersonal power differential is particularly relevant to survivors of MST (Dardis et al., 2016; Smith & Freyd, 2014). Ferenczi (1932) states that an individual’s power over another (i.e., unequal balance of power, control, and status) is traumatic for the person who has less power (Frankel, 1997, 1998) because the person then becomes vulnerable and lacks control (Frankel, 1998).

Ferenczi (19, 1949) describes two types of basic forms of influence that a person in a position of power has over another. Influence may be through love and tenderness, which

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is a maternal form of influence (Blum, 2013; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000). The other form of influence may be through authority or power, which is considered paternal and involves threats and promises of rewards (2013;1932;1998, 2017;2009;2000).

Both forms of influence are not considered entirely destructive as they are a part of normal, healthy relationships. Maternal influence is supportive and nurturing in nature, and paternal influence is more corrective and authoritative. However, the paternal form of influence can be abused by the person in control, and this is what is normally experienced by women survivors of MST (Blum, 2013; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000). In the context of the military, and the women survivors of MST, a perpetrator abuses the paternal influence and coerces the survivor to conform and submit. A perpetrator utilizes authority or power and influences the survivor interpersonally, which causes feelings of vulnerability and a loss of agency in the survivor (2013;1998, 2017;2009;2000). As a direct result, the survivor experiences feelings of helplessness, of being under attack, being overpowered, and terrified by the person who is in authority or has power, which is comparable to what is experienced in the military (Ferenczi, 1932; Frankel, 1998).

Even though Frankel (1998) and Ferenczi (32491932, 1949) were describing incest and sexual abuse by a trusted adult, the same dynamics exist in the military (Dardis et al., 2016; Smith & Freyd, 2014; Wolff & Mills, 2016). This is because perpetrators that are associated with the military are often authority figures or have some form of power (e.g., supervisory position, in the chain of command, physically strong, having a history of

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killing in combat) over the survivor, which is comparable to what is experienced between molesters and children (Dardis et al., 2016; Smith & Freyd, 2014).

Brothers (1992) states that the survival of child incest victims depends on their relationship with the same family member who betrays their trust. The memories of the abusive sexual experience often result in a dissociative split off from consciousness as the trust in the abuser becomes more intense (1992). In the military, women depend on their superiors and peers to effectively perform in their assigned duties. However, women also depend on them for their survival, especially in the war zone. Women who decide to join the military do so for many reasons, but the experience of adult-onset trauma due to sexual harassment or sexual assault by their superiors and peers is not what they expect.

Service women are in a committed relationship, a relationship of care and trust, with the military institution where MST continues to and is perpetrated by those in a position of authority or power (Smith & Freyd, 2013). MST is an interpersonal trauma that involves a betrayal by a trusted individual that can cause lasting physical and psychological harm to the survivor (DePrince & Gleaves, 2007; Fred, 1996, 1994; Lofgreen, 2017; Smith & Freyd, 2013). The betrayal of trust causes the survivor to experience a sense of vulnerability and the inability to protect herself; she becomes fragmented (Brothers, 1992). MST survivors are unable to trust themselves as well as others, and this trust disturbance causes an intensification and diminution of self-trust (1992). The intensification and diminution of self-trust are responsible for the dissociative nature of PTSD symptoms, which are associated with the survivor experiencing a sense of depersonalization and derealization (1992). MST survivors endure feelings of intolerable “humiliation, narcissistic rage, and terrifying experiences of

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fragmentation and depletion” after being sexually assaulted by a trusted and fellow service member (1992).

Conclusion

As a consequence of MST, survivors may feel trivialized and worthless as service members. MST is a dehumanizing and self-esteem shaking experience that can cause a loss of self-cohesion. It can destroy the idealized parent imago that the service member joined the military to merge with. MST may severely affect the emotional and physical wellbeing of the survivor and result in long-term psychological and physiological disturbances.

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Chapter III

My Methodology

Introduction

The purpose of this qualitative phenomenological study is to understand the lived experience of women who continue to live with the effects of MST. This is important because the majority of the research over the last 30 years has been quantitative. Quantitative research has helped us to understand the participants’ experiences from a group perspective, which has resulted in thousands of survivors benefiting from the vast array of programs, services, and evidence-based therapies to help improve the quality of their lives.

However, understanding the individualized and personal experience of the MST survivors is not apparent utilizing the quantitative method. More specifically, the survivors’ words have been generally limited in this approach. Survivors deserve to be heard because many were forced to remain silent in order to survive, maintain their military careers, and to sustain themselves throughout the remainder of their lives.

González-Prats (2020) conducted a phenomenological qualitative study on how survivors perceive the military’s efforts to prevent and respond to MST crimes and how survivors experience and are affected by these efforts. However, there appears to be no qualitative

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study that uses phenomenology methodology utilizing psychodynamic theory with this population.

The primary objective of this research was to explore the complex phenomenon of the lived experience of women who have experienced MST. This qualitative study focused on the subjective experience of how MST survivors experienced their MST incident within the complex world of the military, as well as the long-term effects of the challenges they experience after the military. An in-depth exploration of the lived experience of female survivors provided a deeper understanding of the intrapsychic and interpersonal effects of MST in relation to the internalized military experience. The internalized military experience studied was the meaning of the long-term effects of MST on female survivors and how they are affected by the realization of the interpersonal and institutional betrayal their experience represents. This qualitative study was designed to address the following central research questions: What is the lived experience of female survivors of MST, as well as the effects on them as they continue to age? How do women survivors see themselves in relation to the military and their service to the United States?

The aim of this qualitative phenomenological study s to provide a detailed examination of the lived experience of the phenomenon of MST through the female participants’ personal experiences and personal perceptions of their events. Therefore, the qualitative phenomenological methodology that was utilized in this study was interpretative phenomenological analysis (IPA), which draws from phenomenological inquiry developed by Flowers, Osborn, and Smith (2009).

The IPA methodology explores accounts from a small number of respondents, aiming to develop an understanding of the true essence, in detail, and the subjective

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experiences or worldview. IPA requires a combination of phenomenological and hermeneutic (interpretive) insight to attempt to get as close as possible to the personal experience or essence of the participants, and then the researcher interprets the experience for both the researcher and participants (Smith et al., 2009). In addition, IPA also has an idiographic sensibility that is concerned with the particular (2009). IPA also requires an idiographic focus on the details of the individual, which creates a detailed understanding of the individual as a unique and complex entity (Smith et al., 2009; Morrow, 2005; Ponterotto, 2005).

Using the IPA methodology for this study, participants were expected to be small in number and have shared the experience that is under study (Smith et al., 2009). A homogenous sample was needed to investigate the essence of the participants’ experience (2009) since qualitative methods are particularly suited to examine individuals within their cultural frameworks (Morrow, 2005, p. 253; Morrow et al., 2001).

This chapter describes the study’s research methodology and discussions concerning the following areas: (a) rationale for research approach, (b) description of the research sample, (c) summary of information needed, (d) overview of research design, (e) methods of data collection, (f) analysis and synthesis of data, (g) ethical considerations, (h) issues of trustworthiness, (i) limitations and delimitations of the study.

Rationale for Qualitative Research Design

This research study utilized a phenomenological qualitative design methodology. Qualitative methods are an extensive class of empirical procedures designed to describe and interpret the experiences of research participants in a context-specific setting (Denzin

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& Lincoln, 2000; Ponterotto, 2005). Because qualitative methods focus on the experience of research participants in a context-specific setting, qualitative methods were appropriate for the current study of the lived experiences of survivors of MST. The military is a context-specific setting that plays a significant role in how women who have experienced MST continue to relive their trauma long after leaving the military.

This qualitative approach fosters a constructivist epistemology that is concerned with the relationship between the “knower” (the research participant) and the “would-be knower” (the researcher; Ponterotto, 2005). Epistemology: “Theories of knowledge that justify the knowledge-building process that is actively or consciously adopted by the researcher” (Gringeri et al., 2013, p. 55). According to this definition, constructivist epistemology would consider the researcher’s emotional and expectant stance significant. The researcher is required to acknowledge, describe, and “bracket” his or her values but not eliminate them (Ponterotto, 2005, p. 131). A constructivist epistemology was chosen for this study to illustrate the real-world phenomena and critical awareness of the participants’ lived experiences. These processes were imperative for reinforcing the validity of the study.

This study focused on the experiences of MST survivors and their trauma, as experienced within the military culture, and what this meant to them. During the research process, open-ended questions were utilized to extract participants’ meanings and interpretations of their subjective world experiences. In order to further understand the meaning of the experiences of the participants, qualitative researchers also sought to understand the context or setting of the participants through visiting this context and gathering information personally” (Creswell, 2003). To further understand the meaning

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of the participants’ experience, this qualitative research design used hermeneutic phenomenology to explore MST survivors’ lived experiences.

Rationale for IPA

Phenomenology is a qualitative research method that is transcendental and emphasizes subjectivity and the discovery of these essences of experiences of individuals. A phenomenological study explains the lived experiences of a concept or phenomenon for individuals (Creswell, 2007; Giorgi, 2009; Moustakas, 1994). That is, the focus is on the participants’ experiences and understanding of a particular phenomenon. The phenomenological design typically involves conducting interviews, and its robust philosophical underpinning is conceptualized and defined by Husserl (Creswell, 2014, p. 42; Zahavi, 2003), who suggested that “adopting a phenomenological attitude involves and requires a reflexive move, as we turn our gaze from, for example, objects in the world, and direct it inward, towards our perceptions of those objects” (Smith et al., 2009, p. 12).

Husserl indicated that bracketing, also known as epoche, is a method to ensure that the researcher is suspended from any judgment regarding the true nature of reality (Tufford & Newman, 2010, p. 82). Bracketing is the process of tapping into the essence of the experience (2010). It allowed the researcher to “put to one side, the taken-forgranted world in order to concentrate on our perception of that world” (Smith et al., 2009, p. 13). For Moustakas (1994), bracketing is simply the setting aside of personal prejudices.

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Gadamer (1997) proposes that the aim of bracketing in the research process is to “make intelligible all subjectivity.” Gadamer (1997) then also asserts that making intelligible all subjectivity, which is also known as hermeneutic phenomenology, is not merely a research method, but a stance, a way of being in the world.

The hermeneutic phenomenology used to make the subjectivity intelligible was bracketing, which is a research method. Bracketing is also a stance, a willingness to undergo a process so that “what is” may emerge and show itself (Gadamer, 1997). Bracketing allowed the researcher to simply the set aside personal prejudices (Moustakas, 1994), and tapped into the essence of the experience (Tufford & Newman, 2010). This stance was particularly relevant to the study because the researcher is also a veteran and may have had some knowledge of the military experience of the participants. It was critical for the researcher to bracket her knowledge so that participant experiences could emerge.

Prior to this study, utilizing hermeneutic phenomenology, from a psychodynamic perspective, to understand the lived experiences of female MST survivors, did not exist. There is an absence of research that psychodynamically explores the long-term lived experiences of female MST survivors, as presented in Chapter II. In the opinion of the researcher, this study demanded a constructivist analytical phenomenological approach that sought to understand the intrapsychic and interpersonal experiences from the perspective of the survivors.

The rationale for utilizing a phenomenological qualitative methodology for this study was to understand the complex processes by which women survivors made sense of their lives after experiencing MST. The hermeneutic perspective recognizes that human

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existence is always embedded in a world of meanings, and “phenomenology becomes hermeneutical when its method becomes interpretive rather than purely descriptive” (Bloomberg & Volpe, 2019; Mills & Birks, 2014). Interpreting and understanding why survivors have particular views or perspectives about their MST experience, or reaction, are some of the elements that surfaced during this phenomenological research study.

According to Bloomberg and Volpe (2019), hermeneutic phenomenology requires several in-depth interviews with participants who have experienced the phenomenon of interest. The goal of this type of interviewing is to describe the meaning of a concept or phenomenon that several individuals might share (2019). The hermeneutic phenomenology approach to data collection is based on the assumption that there is a structure and an essence to shared experiences that can be narrated (2019).

Showing the ways in which individual survivors of MST have constructed what happened to them in the military, and the psychological linkages they made for themselves, was crucial to understanding how they have internalized their traumatic experience. Theoretical insight was important to inform this study, which was to show the how individual survivors of MST have constructed what they experienced in the military, and the psychological linkages they made for themselves. This theoretical insight was crucial to understanding how they internalized their traumatic experience. With the understanding the experiences of the participants, the researcher was able create an understanding of the shared experience of MST.

Understanding the shared experience of MST provided a psychodynamic insight into how the participants processed and internalized their military trauma. To support scientific validity, this qualitative study explicitly acknowledged the interpersonal,

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intrapsychic, and intersubjective processes of both the MST survivor and researcher through in-depth interviews. The in-depth interviewing allowed for a self-reflective stance, an “explicit focus on the researcher’s personal experience,” as well as those of the participants by focusing on the “deep lived meanings that guided the participants’ actions and interactions” (Bloomberg & Volpe, 2019). Through the combined experience of the interviewer and the interviewees the lived experience of MST was reflected.

A reflective stance allowed the researcher to discover essential themes that represented the nature of the lived experience (Bloomberg & Volpe, 2019). After the interviewing process, the researcher then wrote a narrative of the phenomenon. By maintaining a strong relationship with the participants allowed the researcher to interpret the meaning of the individual’s lived experience.

Research Sample

The participants for this study were cisgender women who were documented as female during their service in the military and have experienced MST. For the purpose of the study, MST is defined as sexual harassment or assault that occurs in the military. Purposeful sampling was used to recruit survivors. This method of sampling involved selecting participants according to the needs of the study (Moustakas, 1994), which involved examining a unique phenomenon survivors living with the effects of their MST experiences. The sample size was eight adult women between 35 and 57 years old.

The rationale for selecting participants from such a wide age range was to increase the possibility of the study sampling participants from different eras and age groups. The wide age range allowed the researcher to obtain pertinent data, from a variety of

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participants, who have had different life experiences, since leaving the military, and to understand what a variety of age ranges have gone through.

The decision to not target women under the age of 23 for this study was based on the researcher taking into consideration the developmental and emotional maturity levels of the potential participants. The developmental and emotional maturity level was essential to consider because of the potential of women under the age of 35 being adversely affected by talking about their trauma for the first time during the study. This was especially concerning for this age group if the trauma had not been processed on an emotional level prior to the study.

Research suggests individuals between 17 and 24 years old have not reached their pinnacle development or maturation, and would be most at risk of experiencing significant narcissistic injuries if chosen for this study. According to Arain et al. (2013), empirical evidence suggests that the brain does not fully mature until the age of 25. Zapf (2012) reports that most MST incidents occur between the ages of 18 to 24. Service members are eligible to join the military at 17, which is during a vulnerable stage of emotional development. This stage is vulnerable because the maturational completion age for a fully developed brain is 25.

In addition, Palombo (2008) explains, in his paper on Kohut’s (1971) theory of self psychology, that wisdom develops as the brain matures. Palombo also suggests that wisdom may be defined as “an attitude toward life that encompassed a number of maturational and integrative steps” (2008, p. 166). It is unlikely for 17 to 24-year-olds to have achieved full maturational development. It is further suggested that wisdom is strengthened by age, experience, and one’s ability to be reflective when confronted with

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narcissistic injuries. Palombo (2008) stipulates that one has reached pinnacle development when his or her wisdom includes the ability to use a combination of mature cognitive processes and emotions when faced with narcissistic injuries (p. 166). It is unclear that survivors between the ages of 17 and 24 would not have reached their pinnacle development.

Several studies conducted to understand the effects of MST have included participants aged from 18 to 70. However, the average age of the women who completed the studies was between 25 and 65, and the majority of them ranged from 32 to 44 years old. Given that the majority age of the participants in these other studies, it is likely that older participants will complete this study. The participants who completed Brownstone’s (2019) phenomenological study on MST were over 43. In a different study (Monteith et al., 2019), the majority of participants completing a study to determine the severity of mental health symptoms for survivors of MST and institutional betrayal was 48. Rasmussen’s (2016) phenomenological research studied the barriers to reporting MST assaults, and the majority who completed the study were 30 to 43. A research study conducted by O’Brien et al. (2008) included participants whose median age was 44. Freysteinson et al. (2018) conducted hermeneutic phenomenological research to study women who ranged in age from 25 to 63. The majority of the women who completed the study were over the age of 43. Thus far, evidence presented suggests that it is safe to speculate that selecting respondents between the ages of 18 and 24 for the study would not have been conducive to their immediate and long-term well-being.

In IPA, the age range of 35 to 57 allowed for sufficient in-depth engagement with each case and enabled a “detailed examination of similarity and difference, convergence,

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and divergence” (Smith et al., 2009). Respondents selected for this study were of different races, socioeconomic backgrounds and religions, and all had served in every branch of the military except the Air Force and Coast Guards. The participants for this study were selected from Alabama, Illinois, Indiana, Georgia, New Jersey, Oregon, and Texas.

The respondents were considered ineligible to participate in this study if they were challenged with severe short-term memory deficit, exhibited current and severe psychiatric symptoms, other cognitive impairments which could have impeded productive participation in the study, or were incapable of responding to the questions concerning informed consent. In addition, respondents who expressed interest in participating in the study were screened for eligibility. The screening involved the participants answering questions about their MST experience and determining the appropriateness and safety of the study for them.

The screening took place through an online system because a visual process will provide additional information on whether the participant can safely and comfortably participate in this study. The screening took place through an online system because a visual process provided additional information on whether the participant could safely and comfortably participate in this study. Considering that online recruitment made it easier for respondents to falsify their identity, they were required to verify their military service by showing a military identification card or discharge papers (Hamilton & Bowers, 2016, p. 824; Stewart, 2000).

One online system that was used for online interviewing was Zoom, which is a reasonably priced Voice over the Internet Protocol (VoIP) system which permits people

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to make and receive video or audio calls (Cater, n.d.). Communication through Zoom occurred either from a computer-to-computer or from a computer to a phone (Cater, n.d.). To ensure privacy while using Zoom, the researcher used microphone-enabled headphones so that only the researcher could hear the participants’ responses (Cater, n.d.). While Zoom allowed for the recording of both visual and audio, the interviewer only utilized the audio recording option upon receipt of the interviewee’s expressed and written informed consent.

In conjunction with securing the informed written consent from the respondent before the interview began, qualitative research ethics required that the interviewer explain the purpose of the research, how the research would be recorded, how the information would be stored, and then how it would be destroyed (Cater, n.d.). The interviewer also reminded the participants that they had the option to turn off their video conferencing and continue the audio interview only or stop the interview at any time (Cater, n.d.).

Research Design

1. The researcher distributed study flyers to the gatekeepers at local Veteran Service Organizations (VSO) and social media websites. Please see more about the differences between the VSOs and social media websites below. The researcher first connected with the gatekeepers before attempting to recruit participants because they could have potentially either facilitated or hindered the recruitment of participants (Namagey-Funa et al., 2014, p. 10). Gatekeepers are often trusted by

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the targeted population, as well as the leadership of the organizations, and they have proven helpful in promoting other studies (2014, p. 10).

2. Recruiting efforts through these two sources attracted some respondents, but not any participants. Although the two sources provided potential respondents from a diverse pool with systematically different experiences due to the criteria for membership into the VSO, and the relatively open nature of participation in social media websites, no participant was recruited after several months. As a result, the researcher connected with a gatekeeper in the National Council of Negro Women (NCNW). NCNW was established in 1935 to advance opportunities and the quality of life for African American women (Lange, 2022; National Park Service, 2022). NCNW was founded by Mary McLeod Bethune who successfully advocated for African American women to join the Women’s Army Corps (WAC) during War World II in 1943 (2022; 2022). The over 800 African American women served in WAC in Europe, the 6888th Central Postal Directory Battalion, nicknamed the “Six Triple Eight,” which was five years before all women became eligible to join the military in 1948.

A gatekeeper with the NCNW, Delaware Valley Section, helped to facilitate the recruitment of women veterans for this study. As mentioned previously, purposeful sampling was used as the recruitment method for respondents from NCNW. Although only one participant referred by NCNW completed the study, the other respondents and participants were recruited through by snowballing (Anasta, 1999). Respondents and participants identified other potential respondents to participate in the study.

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The study flyer included the name and address of the researcher, how and where the interviews would take place, the phenomenon under study and the purpose of the research, a summary of criteria that would be used to determine eligibility for the study, the time or other commitment required of the subjects, and the person to contact for further information (please refer to Appendix B).

3. Study flyers were distributed in person and via email to VSOs, NCNW, and women veteran-related social media websites and organizations across the United States.

4. When respondents contacted the researcher expressing interest in the study, the following initial phone interview was used to determine their eligibility for the study. An information packet was electronically sent. The packet included a letter detailing the study, including risks, benefits, confidentiality, the consent process, and information on MST-related services and VA benefits. The consent was signed remotely and sent back to the researcher before the initial interview began.

5. Respondents who were eligible participated in two interviews which were conducted remotely using Zoom in a private space. The interviews lasted about 60minutes or more each, and they were recorded with the permission of the participants. A follow-up phone or virtual interview that lasted no more than 60 minutes was provided as needed for clarity. Before the first interview, the participants were emailed a prepared script that would be used during the interview (please refer to Appendix B). The second interview took place one to three weeks following the first interview. A brief third phone interview was added for further clarification of information received during the interviews or for verification of

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themes that emerged. In addition to the above protocol, participants were given the opportunity to review their interview recording and read through their interview transcript and add feedback as needed, which is called member checking. This process increased the validity of the data because the purpose of the study was to understand the lived experience of the survivor. The data obtained through the semi-structured interviews uncovered the shame, guilt, fears, internal struggles, resiliencies, hopes, and other realities of the participants. This methodology followed an interpretative phenomenological analysis (IPA) approach. Questions/prompts for the interview for this study were detailed in the data collection section.

6. After each interview, the researcher conducted reflective journaling, which was utilized as a form of an independent audit (Bloomberg & Volpe, 2019, p. 199). Reflective journaling may be done following an interview or during the data analysis process. It is a critical contribution to the quality and validity of the IPA process as it is an established method of “interpretation and bracketing as a reflective mechanism” (Vicary et al., 2016). Reflective journaling also provided an opportunity for the researcher to use her reflections as an integral part of the research process and creates transparency (Ortlipp, 2008).

7. The recorded interviews were transcribed using Rev.com, an online speech-to-text service with near-verbatim transcription. This speech recognition program transcribes from audio-recorded interviews with a quick turnaround time.

8. Upon receiving the transcribed interviews from Rev.com, the researcher reviewed and coded the transcripts. The researcher also created a synopsis of each interview

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and provided it to the participants, along with the recorded interviews and transcripts. This process helped to provide additional clarification and verification of the interviews

9. The researcher consulted with an advisor after the first several interviews so that the researcher’s own reflection could be brought into the analysis process. The consultation was necessary to encourage the researcher’s deep reflections and the perception of the interviews and identify nonverbal and verbal communication.

Data Collection

Analysis derived from the qualitative data of the IPA process allowed for an in-depth answer to the study’s question: “What is the lived experience of female survivors of MST, as well as the effects on them as they continue to age?” The aim was to elicit detailed, in-depth, rich, and first-person accounts of the participants’ phenomena and experiences. Semi-structured interviews allowed for a flexible dialogue in real-time. The following are the sample interview questions and prompts that were used during the interviews (please also refer to Appendix D):

• What was your reasoning for joining the military?

• How old were you when you joined?

• What did you imagine your experience would be in the military?

• Explain where you were when the MST occurred (at regular duty station or on deployment during a conflict or war)?

• Can you describe your experience with MST, including the timeline?

• How old were you when the incident happened?

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• What was your rank?

• Was the perpetrator in the military at the time, and if so, what was his or her rank?

• Was the perpetrator within your chain of command or had decision power over your career? If so, please explain in detail.

• What did you think and feel during and after the incident?

• What did you think and feel about yourself?

• How did the perpetrator treat you afterward?

• Who did you turn to for help or support?

• What was your experience like during and after you received help or support?

• If you were discharged from the military for reporting the incident, what was your experience?

• If you did not report your MST incident, what was your experience throughout the remainder of your military tenure or career?

• How long did you remain in the military after the MST experience?

• What thoughts and feelings do you have about the MST experience today?

• What thoughts and feelings do you have today about your military experience? Explain that this question is too broad to the review board.

• What thoughts and feelings do you have about the military today?

• What is your relationship with the military, or veteran community, today?

• What do you think you would have accomplished if you did not experience MST? Do you believe MST held you back in things you wanted to accomplish in life? If so, how?

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• How has your MST experience impacted your life, that of your family?

• How has it impacted your health?

• If you have received, or are receiving, medical and mental health for the MST, please provide detailed information about your treatment.

• Have you ever experienced thoughts of not wanting to wake up the next morning, not wanting to exist . . .? If so, please explain?

• Overall, what does your military experience mean to you?

• Have you ever heard of the Tailhook investigation?

Potential additional prompts:

• How long have you been involved in treatment for MST?

• What has been your experience with treatment for MST?

• What was the rank of the perpetrator, and did he or she outrank you?

Plan for Data Analysis

The data was analyzed following the guidelines of IPA. The analysis was “an iterative process of fluid description and engagement with the transcript” (Bloomberg & Volpe, 2019, p. 235; Smith et al., 2009, p. 81). The iterative process for this study involved transcription; listening, reading, and re-reading; initial noting; developing emergent themes; searching for connections across emergent themes, and a composite description.

Each step consisted of the following:

1. Transcription: During the transcription process, significant statements, sentences, and quotes were highlighted and reflected upon. This process, called

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horizontalization, helped to provide a more in-depth understanding of how female survivors are affected by their MST experience as well as how they are affected as they continue to age (Creswell, 2007).

2. Listening, reading, and re-reading: Repeated listening and reading allowed for the discovery of embedded accounts of the lived experiences in addition to gaining an understanding of how the individual narratives bonded certain sections of the interview together (Smith et al., 2009, p. 82). Each re-listening and re-reading helped the researcher to become more immersed in the data. The goal was to gain new insights with each re-listening and re-reading.

3. Initial Noting: The most time-consuming part of the data analysis was notetaking. Smith et al. (2009) explains, “The aim here was to produce a comprehensive and detailed set of notes and comments on the data” (p. 83). This process was intended to bring forth key themes that reflect the source material.

4. Developing emergent themes: Here, the main task was to turn previous notes into emergent themes that reflect not only the participants’ original words but also the researcher’s reflections and interpretations. The themes brought together a range of understandings relating to both the participant and the researcher.

5. Searching for connections across emergent themes: Smith et al. (2009) assert “this level of analysis was not prescriptive, and the researcher was encouraged to explore and innovate in terms of organizing the analysis” (p. 96). The analysis, not being prescriptive, did allow for the data to be viewed and interpreted in different ways. The authors suggest the following methods for the analytic process:

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• Abstraction: Is a basic form of identifying patterns between emergent themes and developing a sense of superordinate themes, which emerge at a higher level as a result of putting themes together.

• Subsumption: Is a process that is similar to abstraction but brings together a series of related themes.

• Polarization: Is a process in which the researcher identifies oppositional relationships between emergent themes by focusing on differences between the themes

• Contextualization: Is a process that allows the researcher to examine the contextual or narrative elements within the emergent themes.

• Numeration: Is taking into account the frequency with which a theme is supported.

• Function: Is the examination of themes for their specific function within the transcript.

• Bringing it together: In the process of combining all of the previous steps.

• In the final step, a composite description based on the experiences of all the participants will be written, which will present the “essence” of the phenomenon of living with the effects of MST.

Ethical Considerations

The risks to individuals participating in this project included experiencing strong effects and heightened emotions due to the emotional intensity of the content, including issues related to being retraumatized or re-experiencing the MST event(s). Additionally,

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participants could have become triggered by some of the questions that were asked. To reduce the adverse impact of these situations, the researcher took all steps necessary to minimize these risks, including providing a listing of local VA facilities and communitybased mental health programs in the participant’s community, stopping the interview when needed, and informing the participants that they could end the interview at any time. Further, participants were also given VA informational MST fact sheets that explain services and programs that are available to survivors, regardless of the type of military discharge. The participants were encouraged to follow up with their VA or communitybased mental health provider. The contact information to the Veterans’ Crisis Hotline and the Vet Center 24-Hour Call Center were provided before the interviews began.

Precautions made to minimize risk included maintaining confidentiality throughout the entire project. To ensure the participants’ confidentiality, no identifying information was placed on any research materials, and participants were able to choose from a list of pseudonym names provided by the researcher. A list tying the false participant names with their true identification information was kept in the researcher’s office under lock and key, and this list was destroyed at the conclusion of the data collection. As the data was collected, password-protected computer databases were utilized for data input, and only the researcher will have access to the data and databases. The informed consent stated that the participants would be asked about their family experiences. Participants were told that they did not have to answer any questions they found upsetting or did not want to answer. It was announced early by the researcher that if the participant experienced distress, the researcher would cease asking questions until the participant

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agreed to continue the process. If a participant required an emergency response because of their participation in the research study, the researcher would take the steps necessary.

Issues of Trustworthiness for Qualitative or Mixed Methods

This section discusses the trustworthiness or credibility of this research study. Several strategies were utilized to ensure data credibility, transferability, and reliability, including the collection and comparison of data quality, clarification of the data which was collected from the participants during intense and lengthy interactions with them. A major strength of qualitative research is validity, which is based on determining accuracy from the viewpoint of the researcher and participant (Creswell & Miller, 2000). To determine the validity of qualitative research, the standards of quality (i.e., credibility, rigor, or trustworthiness) must be met (Morrow, 2000, 2005). Credibility was established through the perspective of the participants that were interviewed. Bloomberg & Volpe (2019) indicate that it is the researcher’s responsibility to accurately portray the participants’ thoughts, feelings, and actions during the study (p. 202); thus, the purpose of using IPA as a methodology in this study was to describe or understand the phenomena from the participant’s perspective or lived experience.

The researcher ensured credibility by video and audio recording the interviews, reflectively journaling, and allowing for member checking and debriefing (Bloomberg & Volpe, 2019). Member checking offered validation by allowing the participants to review their recordings and transcript for verification, and the researcher documented their feedback (2019, p. 199). Member checking also provided the opportunity to gain additional data from the participants (2019). Further, to ensure credibility, participants

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were asked to verify their identity by showing their military identification card or military discharge documents.

Dependability or reliability requires that the researcher account for and describe the changes that occur within the research setting and how these changes affect the way the research is conducted. It was the goal of the researcher to be consistent across time and analysis techniques, which is the standard Morrow (2005) recommends to ensure reliability. Ensuring reliability was achieved by having a process through which emerging themes would be explicit and repeatable (p. 252). Morrow suggests that to accomplish this, the researcher would need to vigilantly track the emerging research design and maintain an audit trail (2005). This involves a detailed chronology of research activities and processes (2005). A chronology of research activities and processes consists of documenting any influences on the data collection and analysis (e.g., emerging themes, categories, digital records, and reflective journaling). It was the intention of the researcher to fully comply with the requirements of maintaining a chronology of activities and processes throughout the study, including meeting and discussing the data collection with the dissertation chairperson or committee. Additionally, codes were created, and they were used with each interview to further ensure the reliability of the data.

Transferability is primarily the responsibility of the qualitative researcher to describe the research context and the assumptions and limitations that are central to the research. The transferability of this study is that it can be conducted in other settings (Bloomberg & Volpe, 2019; Morrow, 2005). By providing a thick and rich description, and detailed information about the context and background of the study, it is anticipated that

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knowledge produced by this study can be assessed for applicability and applied to other similar settings (Bloomberg & Volpe, 2019). However, the aim of this study was not to simply generalize findings but to add to the psychoanalytic literature (Bloomberg & Volpe, 2019; Lincoln & Guba, 2000) by providing insight into the long-term effects of understanding how MST is internalized for the survivor.

Limitations and Delimitations

A principal concern of this study was the issue of subjectivity and potential bias of the researcher being a veteran and a therapist at the VA. In addition, there might have been limitations. Accordingly, limitations flow from implicit characteristics of design and methods (Bloomberg & Volpe, 2019). Thus, it was important for this study to not just be from the perspective of the researcher but from the perspective of the participants; therefore, the nature of this qualitative research gained an understanding of the lived experiences of the MST survivors in an in-depth manner.

I attempted to increase reliability throughout the interpretative phenomenological analysis, reflective journaling, and regular consultation with the dissertation chairperson or committee. Further, I employed the use of bracketing by listing my preconceived notions and discussing them with my dissertation chair. I made every effort to set aside my personal conceptions during the interview, and data analysis, which was an additional effort to ensure reliability, as the essences and meanings only evolved from the data.

Delimitations define and clarify the conceptual boundaries of a research project (Bloomberg & Volpe, 2019, p. 225). A major delimitation of this study was that the scope and the research sample were restricted to a limited sample size of 20 (p. 225). The

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sample size of this research wase 8 participants, thereby limiting the possibility of it being generalized into larger studies.

The Role and Background of the Researcher

This researcher is a licensed clinical professional counselor, clinical director, and a certified drug and alcohol counselor, who provides comprehensive assessment and counseling services to adult males, females, and their families. My work is informed by advanced training in contemporary psychodynamic theory in combination with over 30 years of clinical experience. The researcher specializes in the treatment of adult-onset trauma experienced by military service members and veterans who experienced combat or MST. The role of the researcher also encompasses managing a clinical readjustment counseling program under the VA, comprising of clinical and administrative personnel.

In my previous employment, the researcher collected psychological data on military recruits with an emphasis on the determination of their suitability for continued Naval service or specific fitness for duty within the DoD. The researcher also conducted intake interviews on referred recruit personnel and provided potential diagnoses. Prior to working for the DoD, the researcher specialized in identifying, assessing, and treating both male and female children and adolescents for physical and sexual abuse. The researcher also prepared cases, testified in court hearings, and managed a specialized foster care program. Furthermore, as an Air Force veteran, this researcher personally experienced military indoctrination as an enlisted service member for over seven years.

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Chapter IV Results

Introduction

For this study, the lived experience of MST survivors was explored. The purpose of this qualitative phenomenological study was to explore and understand the meaning of MST from the lived experience of women who served in the United States Armed Forces as well as its long-term effects (on them), and to ascertain how the survivors have been affected by the realization of the interpersonal and institutional betrayal their experience represented on intrapsychic and interpersonal levels. The interpretative phenomenological analysis was the qualitative methodology that was utilized to address the nuances of the experiences of the survivors who participated in this study and to explore in detail how they made sense of their experience.

The results of this research study can be distilled into six themes after analyzing the 16 interviews from eight female participants who experienced MST. Each participant’s description of their internalized trauma from the military is unique to them; however, this chapter offers a synopsis of the responses representing a collective voice of all the participants. As described in the methodology chapter of this study, every interview was transcribed, each sentence was broken down and analyzed into discreet data. The data was reorganized into six themes with descriptive properties. Member checking was conducted by providing the participants digital access to their two interviews and two

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transcripts after each scheduled meeting. Afterwards, the researcher provided a comprehensive written summary of the interviews to each participant for their review to ensure accuracy. The member checking process clarified the interviews and provided additional information.

To begin, some of the results require some context in order to be fully understood. This is specifically the case with the importance of signing the commitment contract and recruit (boot camp and basic) training. All of the participants mentioned their experiences with MST began in recruit training. Therefore, an explanation of the commitment contract and recruit training are necessary to make sense of how it can play an important role in setting up the conditions in which MST becomes possible. Therefore, this chapter will first discuss the indoctrination process of signing the commitment contract and the recruit training to allow for a clearer understanding of how the nuances of the signing the contract and military training, and when abused, can be negatively internalized by MST survivors. Next, this chapter provides a description of the participants’ trauma and a discussion of the six themes.

Where It All Begins: The Contract and Indoctrination

Joining the military is an iron-clad contractual obligation, which has severe repercussions if the recruits fail to meet established standards. Recruits begin the process of learning that they could lose their military career for failing to follow orders or not adhering to the Uniform Code of Military Justice (UMCJ). The loss of their military career may result in a dishonorable discharge which can interfere with getting a job and establishing a career. For example, most Fortune 500 companies and government

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agencies require an honorable discharge from the military for employment. A person with a less than honorable discharge is often unable to qualify for federal loans to purchase a home or start a business. The repercussions of being kicked out of the military can affect many areas in the person’s life (e.g., underemployment, homelessness, etc.).

Understanding the consequences of violating the commitment contract will help clarify why the anxiety and dread of the severe repercussions of potentially losing their military career are internalized within the participants.

Upon entering the military, all recruits are required to complete an intense and rigorous indoctrination program called recruit (boot camp or basic) training that prepares them for the physical, mental, and emotional elements of military service (DoD, 2022a). The Marine Corps’ boot camp is 13 weeks (DoD, 2022a). The recruit training for both the Army and Navy is 10 weeks, for the Air Force 8.5 weeks, and for the Coast Guard 8 weeks (DoD, 2022a). The intensive military program consists of physical training, field exercises, and academic classes that are supervised by drill sergeants or drill instructors. Drill sergeants are also responsible for ensuring that recruits are fully prepared for everyday challenges, including dangers in the field and the rigors of war. The training further involves teaching military laws, customs, traditions, and history facilitated by the drill instructors. One of the most important customs taught early during the training is military bearing. Military bearing includes obeying laws, rules, and regulations, and following orders given by superiors.

Recruits learn early during the training to adhere and conform to the military rules and laws, as well as emulate the behaviors and actions of their superiors, in order to complete the indoctrination process into the military. Adhering to and following orders

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are taught first, then the trainees learn the rules and laws that govern military service.

Trainees do as they are told, and they do not question the authority of the drill sergeants and officers. Trainees are told that everything that they do will be dictated by the drill sergeants. They are told what to wear and how to stand and walk. Women trainees are not allowed to wear makeup, fragrances, jewelry, or fancy hairstyles. Their appearance and attire are basic and standardized, down to their underwear. They are even instructed on how to make their bed and how to fold their clothes, including their socks and underwear.

The drill sergeants will also dictate when the trainees will eat, sleep, use the bathroom, and bathe.

The program is designed to be challenging. During the first few days of training, the trainees learn quickly how insignificant and vulnerable they are. They are stripped of anything that links them to their civilian life, and they are identified by only their last name and the last four digits of their social security number. The trainees are emotionally broken down and physically overextended, they are terrorized and yelled at daily as they are constantly told what to do. Trainees sleeping comfortably is not an option. They are awakened at any hour to perform any type of task, regardless of how menial or strenuous. Trainees are often exhausted.

Under these conditions, recruits who may have been able to manage their previous traumas become less able to. The effects of their pre-military traumas may rise to the surface during the rigor of training, which, from the perspective of the DoD, is preferrable to occur during the training and not afterwards. It is preferred that a trainee exhibit any mental or emotional instabilities during the training because this gives the military the opportunity to assess and determine if the trainee is fit to remain in the

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military and capable of handling extreme levels of stress in a warlike situation before reporting to their permanent duty station (where the trainee will live and work) upon the completion of the initial trainings.

Even though military training pushes recruits to their breaking point in physical, emotional, psychological, and academic ways, not all will experience a psychotic break; most will make it all the way through and graduate. This is where this challenging and seemingly abusive program can have a rewarding outcome for the recruit. They learn that they can achieve more than they could ever imagine and develop a sense of accomplishment and empowerment. So, the completion of training leads to benefits such as a sense of self-empowerment, camaraderie, esprit de corps, and the realization of being able to both sustain and achieve success while handling high-stress situations or functions during war.

The training program is facilitated by drill instructors who teach recruits how to care for themselves and others and succeed as part of a team. Recruits learn to think and function collectively. Functioning and thinking as part of a team is enforced and accomplished by having recruits do almost everything together (e.g., shower, dress, exercise, and sleep). This collective action forced on the recruits establishes the foundation for controlling their thinking and influencing a new set of values (Fairweather, 2019). The controlling of thoughts and establishing a new set of values in recruits are necessary steps in creating a collective and cohesive military mindset, thereby laying the groundwork for recruits’ not only following orders but also understanding the importance of following orders.

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On a psychological level, the intense training involves first deconstructing new recruits’ beliefs, and then reconstructing new beliefs to align with those of the military uniformed culture. As mentioned above, the drill sergeants accomplish this by verbally and emotionally tearing the recruit down quickly and unapologetically. The recruits are rebuilt and molded into exemplary military members, who are trained to be in control of their emotions in all situations, and at all times. The program aims to reconfigure the recruit’s individuality and personality traits that were learned as a civilian and replace them with the attributes of a ready-for-war military service member. This focus on controlling one’s emotions, functioning collectively, and learning to follow orders emboldens the primacy of martial values over civilian values and glorifies its dominance and power in the world order and over the recruits and trainees.

The glorification of dominance and power projected in the military over the recruits and trainees is discussed in detail in Chapter II of this study. The military’s psychological and physical dominance and power over the recruits and trainees is ingrained in them, which reinforces machismo and misogyny and trains service members to be tough, stoic, and to dehumanize the enemy in order to be able to annihilate them (Dickerson, 2022; Litz, 2014). As mentioned previously, studies on the military’s hypermasculine environment and its rape acceptance culture suggest that the military culture encourages male members to have negative attitudes about female service members (Crall & Goodfriend, 2016; Dickerson, 2022; Lee, 2016; Lehner, 2018; Rosenthal & Korb, 2013).

Additionally, the projection of dominance and power over others suggests that the military is a hypermasculine environment where the possibility of sexual assault is almost expected (Dickerson, 2022; Zaleski, 2015). This context then explains how problematic

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the experience of sexual assault and harassment is in the military, not only because it is pervasive and the experiences are horrific, but also because service members are often denied any real recourse or vindication (Dickerson, 2022; Mondragon, 2015; Zaleski, 2015). Further, recruits and trainees are powerless to defend themselves against MST or trust that they will not be retaliated against by their peers and superiors. Feeling powerless and being unable to trust, especially during the intensive physical and psychological military training, places them in a vulnerable position to experience MST.

The recruits and trainees are vulnerable because they can be sexually harassed or assaulted by their drill sergeants, or other superiors, the people who are responsible for facilitating their training and encouraging them to meet the military’s established goals. The drill sergeants determine who passes or fails and if the recruits and trainees can remain in the military or not. The remainder of their career and life are dependent upon the drill sergeants.

The foregoing explanation of the military commitment contract, and the initial training, underscores the significance of acknowledging the vulnerable position the recruits and trainees are faced with when they start their military career. Although Chapter II establishes the groundwork for understanding and defining MST, it does not explain how the commitment contract and military training increase the vulnerability of the service member, especially when they are abused by those who are in positions of power. The commitment and training experience can initiate loose threads of anxiety and despair, which may become entrenched when MST is experienced while serving in the military (Lofgreen et al., 2017). The women who participated in this study felt this

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vulnerability. Therefore, it was important to lay out this context before discussing the responses of the participants.

The next section of this qualitative study summarizes the responses from the eight veteran women who participated in this research. The participants provided a detailed account of their reasons for joining the military, how they experienced and internalized their recruit training programs and careers, what their MST entailed, and their subsequent disillusionment with the military. The participants revealed how some felt compelled to maintain their military bearing and commitment to the mission during ongoing MST violations. Their detailed account represents a collective voice of the survivors suggesting that, for over 40 years, the DoD has become increasingly aware of the pervasive nature of MST, and the progress in curtailing it has been minimal and ineffective. The survivors’ collective voice also reveals the significant physical, psychological, behavioral, and relational consequences associated with their MST.

Introduction of the Participants

The participants for this qualitative study were selected from Alabama, Illinois, Indiana, Georgia, New Jersey, Oregon, and Texas. The sample included eight participants who all served in a branch of the United States military, their ages ranging from 35 to 58 (see Table 1), and they also ranged from being employed and successful in their field to being destitute.

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Description of the Participants

Participant Age Age of Entry Race Residence Military Branch

Total Years or Months of Service

Imagination 35 18 African American Texas Army 8 to 10 years

Strength 56 18 African American Illinois Army 6 to 8 years

Power 48 18 Caucasian Oregon Navy 6 to 8 years Understanding 58 18 Caucasian Alabama Marines 2 to 3 years

Determination 57 18 African American Illinois Army 8 to 10 years

Wisdom 40 18 Caucasian Indiana Army 11 to 13 years

Love 57 18 African American Illinois Army 3 to 5 months

Faith 55 21 African American New Jersey Army

17 to 18 years Retired (medically)

Table 2 provides a description of the types of discharges from the military the participants received, whether the perpetrator was a peer or superior, and if the participants experienced retaliation or institutional betrayal.

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1

Types of Discharges, Perpetrators, and History of Retaliation or Institutional Betrayal

Participant Type of Discharge Superior Perpetrator Peer or Subordinate Perpetrator

Experienced Retaliation Experienced Institutional Betrayal

Imagination Honorable Yes Yes Yes Yes

Strength Honorable No Yes Yes Yes

Power Honorable Yes Yes Yes Yes

Understanding Other-thanHonorable Yes No Yes Yes

Determination Honorable Yes No No No

Wisdom Honorable Yes Yes Yes Yes

Love Uncharacteristic Yes No No Yes

Faith Honorable Yes Yes No Yes

All interviews were conducted using Zoom and transcribed by Rev.com. The following is an unpublished poem written by a women veteran and survivor of MST who asked to have her poem included in this study; her poem will serve as an introduction to the participants’ lived experience documented in this chapter. As can be observed in the riveting poem below, indelible marks of trauma are left in the mind after each reading.

My Superior

I cannot be convicted of suicide, but I can be convicted of murder if you stay Not of my own free will, but in your bed, I laid

Forcibly I was chosen to play your game Beaten because I refused to say your name

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Table 2

Power and confusion were your end game

Your actions left me hopeless and ashamed

Defenseless and now tamed

I became open to screaming your name

Just……anything to get you to STOP

And now I cannot get you off of my brain

Your selfishness, immorality and utter disdain

For anyone’s life but your own is quite insane How could you do this to me

I was supposed to look up to you but never from my knees

You made me beg and plead

And for what, a black eye and a nosebleed

While you traversed my body, I begged you PLEASE

Not to reveal the innermost parts of me

They were not yours to reveal, instead you chose to steal

The most important thing that belonged to me

MY...INNOCENCE!!!!!

Now I cry blood from my eyes like the Virgin Mary

Tainted, my womb now scares me

My lips mouth words that my ears no longer hear

Because these lips and this body does not belong to me

No number of showers will rinse off what you have done to me

I cannot focus, I cannot sleep

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I cannot live, I cannot breathe

YOU…TOOK…THE…LIFE…FROM…ME

So, NO! I will not be quiet anymore

I will not turn my head when you walk past my door

I will stand strong and speak out

Let my voice be heard aloud

YOU TRIED TO MAKE ME A VICTIM BUT I WILL ARISE THE VICTOR!!!!!!! (Bolden, n.d.)

The Participants

Imagination.

Imagination is an African American Army veteran. Joining the military allowed Imagination to escape poverty, but it also caused her to constantly be apprehensive and hypervigilant about her safety every day. She understood early, during basic training, that she had to do whatever she was told if she was going to survive and pass. During the first few days of training, Imagination recalls having it drilled into her head that the drill sergeants are like gods and had the power and authority to make the trainees’ lives miserable during the training or ruin the remainder of their lives by giving them a dishonorable discharge. She also observed that many of the young female trainees were kicked out of the military for failing to follow orders, presenting with a mental disorder,

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and other reasons unknown to her. Imagination knew that she did not want to go through what those female trainees, who were kicked out, experienced. Imagination joined the military to improve her life. She felt that the military was her best option to ensure better life experiences. Unfortunately, Imagination’s MST incidents began during basic training. Initially, there were sexualized statements made by male peers and her drill sergeant. By the second or third week of training, the drill sergeant instructed both Imagination and her battle buddy to report to his private room in the dorm. The young trainees were supposed to have been in bed, and they were wearing their underwear, but they did as they were ordered. While standing at attention, Imagination and the battle buddy were forced to listen to the drill instructor’s details of his sexually explicit exploits. After several minutes of verbally sexually harassing both female trainees, he ordered the battle buddy to wait in his private bathroom. As soon as the battle buddy left the room, the drill sergeant attempted to rape Imagination. She repeatedly, but respectfully, told him no. The drill sergeant groped Imagination and tried to disrobe her. In her efforts to stop the attempted raped and not make the drill sergeant angry, she gently kept removing and blocked his hands as he tried to rape her. In trying to prevent being raped by her drill sergeant, and not make him angry, Imagination was overwhelmed and exhausted. Imagination wanted to remain in the military so she would experience a better life (e.g., more stable, safer, and more consistent) than the one she left behind. She did not want to fail. Imagination continued to gently fight off her drill sergeant as he tried to rape her. After several seconds of standing in the bathroom as ordered, for some unknown

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reason, the battle buddy timidly returned to the room and stood where the drill sergeant could see her. Apparently, she was just as afraid as Imagination of being kicked out of the military. Still, she disregarded the drill sergeant’s order anyway and returned to the room.

Upon her re-entry to the room, the sergeant abruptly stopped his efforts to rape Imagination. Then, as if his actions were normal and above reproach, he rudely dismissed the young trainees and ordered them to return to their beds.

In an effort to try to make sense of the insane actions of the drill sergeant, Imagination began blaming herself, “I should have never gone into his personal space.” Although Imagination and her battle buddy were ordered to report to the drill sergeant’s private living area of the female dorm during the middle of the night, she internalized the MST incident as something she caused. However, Imagination and the battle buddy did not have a choice. They did as they were ordered. Not in their wildest dreams did they expect that reporting to the drill sergeant’s living quarters as instructed would have led to an attempted rape of at least one of them. How does one say no to the drill sergeant who has power and authority over the trainees?

Before the attempted rape, the drill sergeant was nice, and he “just” sexually harassed Imagination. However, after the attempted rape, he criticized everything Imagination and her battle buddy did. They were forced to perform extra duties and exercises and were pushed past the point that other recruits were pushed. Their bodies ached after the end of each day. As far as the drill sergeant was concerned, Imagination and the battle buddy “could do nothing right.” His actions towards the women were venomous and torturous. According to Imagination, the drill sergeant engaged in retaliatory behavior towards the women after the attempted rape. He was angry at both

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women because he was not able to rape Imagination, and this was because the battle buddy returned to the room.

The drill sergeant even harassed Imagination whenever she received letters from her boyfriend back home. The intensity of the harassment led to Imagination telling her boyfriend not to write to her while she was in training, and this caused a rift in their relationship. The boyfriend accused Imagination of having a relationship with the drill sergeant. Imagination and her boyfriend broke up because of the drill sergeant’s retaliatory and harassing behavior. No matter how unreasonable the drill sergeant’s commands were, she followed all of them because she was trying to survive basic training. She was trying to get through training and have a career in the military to improve her life. The drill sergeant even intensified his efforts in harassing Imagination when the training moved to real-world simulation in the field. In addition to forcing her and her battle buddy to perform extra physical work and exercises, the drill sergeant groped and hit Imagination whenever he thought no one was looking. He also threw rocks at her and slapped her on the butt.

At some point, a high-ranking female drill sergeant noticed that the male sergeant was paying too much attention to Imagination and her battle buddy. It was suspected that the female and male drill sergeants were in a relationship. Instead of the female drill sergeant having some compassion for Imagination and the battle buddy, she also began harassing them. The intensity of the harassment from the female drill sergeant made the training even more unbearable for Imagination and her battle buddy. Whatever the male drill sergeant made Imagination and the battle buddy do, the female drill sergeant forced them to do the same but “a hundred times worse.” Imagination was miserable. The

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training was made so much worse by the female drill sergeant. Imagination cried in her pillow every night.

Imagination was confused about why she was targeted and why she could not just train like the other female trainees. The methodical and vicious nature of the ongoing harassment by the female drill sergeant seems to indicate that she tried to destroy Imagination and her battle buddy mentally and physically, as well as crush their spirits so they would fail. Imagination internalized that the abuse she and her battle buddy endured was her fault, even though she had no control or autonomy while in basic training. Imagination endured the abusive behavior by the drill sergeants because she did not want to be sent back home, which she equated to being a failure. Reporting the persistent sexual harassment by the drill sergeant and the vindictive and retaliatory actions by him and the female drill sergeant meant that the young women would have been sent home with an under-than-honorable discharge. The life-improving opportunities that Imagination joined the military for would have been forfeited if she made a report, fought back, or refused to follow their orders. In addition, Imagination felt that the abuse she experienced was her fault. Again, Imagination tolerated the abusive behavior by the drill sergeants because she did not want to be sent home with an undesirable discharge, which she equated with as being a failure. Further, there was an indication that her battle buddy also feared losing her career because she never reported the abuse.

Basic training is designed to be challenging and rewarding, but not impossible or brutalizing. Imagination and her battle buddy were mistreated throughout basic training. They were mistreated by the male drill sergeant because he was unable to rape her, and the female drill instructor abused them because she was jealous. The female drill sergeant

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took her anger out on Imagination and her battle buddy, even though she knew the young women were powerless during training. The female drill instructor retaliated against Imagination and her battle buddy because the male drill sergeant was attracted to at least one of them. It did not matter to the female drill sergeant that Imagination and her battle buddy were 18 years old and vulnerable trainees who had no power or autonomy while in training.

Imagination and her battle buddy endured the abuse until the end of training. They survived. After Imagination survived basic training, she wanted to make the military her career. Her first duty station was in Germany. She had been there for six months when her first sergeant and other high-ranking non-commissioned officers unlocked her dorm room door and walked in without knocking. Imagination was walking out of her shower when the men walked inside. Although she was naked, Imagination had to stand at attention. Her superiors did not give her permission to dress. Her superiors, all men, just silently stared at her for several seconds and then walked out. The men later claimed they were conducting dorm room inspections and thought she would be at work when they entered. Imagination said the same men who walked into her room and stared at her naked body were the men who scheduled her to work nights and knew she had just gotten off work. She believes that the men came to her room hoping to catch her in a compromising position.

Another incident occurred while at her next duty assignment in South Carolina. By the time Imagination arrived at her new base, she had achieved the rank of sergeant. Imagination ran into one of the female drill sergeants who witnessed the mistreatment she endured by the two abusive drill sergeants while in basic training. The drill sergeant who

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witnessed the abuse stated that she was surprised Imagination was still in the military, “I didn’t think you were going to make it . . . and you’re a sergeant now.” The drill sergeant acknowledged that what Imagination and her battle buddy experienced was over-the-line and abusive. Imagination indicated that she was flabbergasted and insulted that the witness was so bold and insensitive to speak to her and reminiscence about the abuse, “She didn’t even help us. She said nothing to stop them.” Imagination felt that the witness was complacent and should have done something to try to stop the abuse.

Also, while Imagination was stationed in North Carolina, she experienced a soldier stalking her one night. Imagination initially became aware that she was being followed when she left the gym on base. The soldier followed her from the base as she drove five miles on the highway to her apartment complex. Every turn Imagination made the soldier made. When Imagination confirmed her suspicion that she was being followed, she changed her destination to keep the soldier from finding out where she lived. The soldier realized that he had been discovered and drove next to Imagination at the next stoplight. He introduced himself and told Imagination that they were in the same company on base. He followed her because he wanted to tell her that he liked her. After informing the soldier that his actions were inappropriate, she reported him to her commander and first sergeant the next day.

The first sergeant and commander only spoke to the soldier, but no disciplinary actions were taken. The soldier retaliated by spreading rumors that Imagination was “gay.” Imagination reported the retaliatory behavior by the soldier to her first sergeant and commander, and they laughed and said, “The rumor will eventually go away.” Nothing was done to admonish the soldier who stalked Imagination. She even sought

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advice from a military attorney, only to be told she did not have a case. After Imagination’s realization that she could never feel safe while serving in “this man’s Army,” she sought the assistance of her first sergeant, who downplayed the incident and ignored the behavior of the soldier who stalked her, and then started rumors about her sexuality because she rejected his advances. The first sergeant allowed Imagination to pursue separating from the military.

After each MST incident, Imagination felt unsafe and fearful. These feelings describe what Imagination experienced almost daily since being in the military. Although Imagination left the military better equipped educationally and financially, the internalization of the traumas she endured in the military affected her intra-psychically and interpersonally. These feelings have permeated her being and have affected every aspect of her life and relationships. She lives in constant fear, experiencing feelings of impending doom or “expecting something catastrophic that will happen.” She describes herself as almost always being in survival mode. Living in a constant state of hypervigilance has not only adversely affected her life and relationships but has also grossly affected her work as a realtor. She feels unsafe working with and showing properties to single men.

Imagination feels as if the military has a predatory culture and purposely chooses not to stop MST. Assigning battle buddies to women recruits was possibly the military’s attempt to curtail the frequency of MST. However, the drill sergeant was not intimidated or curtailed by the battle buddy assignment policy. He still sexually harassed Imagination every day for weeks before calling her and her battle buddy into his personal area for the

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attempted rape. He continued to harass her daily until she completed the ten weeks of military training.

Imagination has mixed feelings about her decision to join the military in the first place. She did achieve some of the things she wanted to accomplish (i.e., improved her life situation, received job training, paid for college, and improved her financial status). However, Imagination inherited several other issues. Some of the issues include her inability to trust, becoming easily agitated and irritable, not being able to sleep, being emotionally numb, being hyperalert in her surroundings, and being easily startled. She also spends a great deal of her time alone, and she has a negative outlook on life.

Imagination describes herself as always being in a “protective mode.”

Her husband describes her as depressed. Imagination feels fortunate that her husband accepts her eccentric ways. She is a realtor and carries some form of protection to ensure her safety. Whenever she is scheduled to show properties to a single man, she is triggered by the thought of conducting a house showing alone with a single man and requires her husband to go with her. Even with the assurance that she has a weapon on her during property showings, Imagination still chooses not to chance her safety by meeting with a single man alone. She feels that something catastrophic could happen to her. This interferes with her ability to make money, but she would rather forfeit making money than put herself in a situation she felt would make her vulnerable. As a result of her experience in the Army, Imagination said she would never encourage another woman to join the military.

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Strength.

Strength, an African American, was a sergeant and dental technician in the Army, who had been at her duty station in Kansas for over a year, when she was publicly assaulted at an informal military dinner. Her company commander, first sergeant, and supervisor were all in attendance and were witnesses. Upon entering the event, Strength walked up to her superiors to say hello and, at that moment, she was slapped on her buttocks by a lower-ranking soldier who recently joined the military. He was Caucasian, like her superiors. Strength was publicly assaulted and humiliated in front of everyone she worked with, including her company commander and the first sergeant. She responded by reprimanding the lower ranking soldier who had slapped her.

Immediately, higher ranking military women whisked her away from the event, demanding that she stop making a scene. Strength was confused as to why the military women whisked her from the scene and not the perpetrator. She felt she was being admonished for loudly rebuking the perpetrator for assaulting her. Strength did not understand why she was being admonished, “I didn’t do anything wrong.” Everyone with the power to protect and validate her as an equal and a valued military member witnessed the assault said nothing. She was alone in a room filled with fellow and superior military members. Strength was African American and the perpetrator and most of the witnesses were Caucasian.

Strength was publicly sexually assaulted, and no one came to her rescue. She was abruptly removed from the party by higher-ranking military women who were trying to preserve her career and the integrity of the informal dining event. Strength felt that no one cared about her emotional and mental wellbeing. There is no evidence that the

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perpetrator was ever reprimanded or even instructed to not engage in sexually harassing behavior towards Strength. Although his blatant behavior was publicly witnessed by high ranking commissioned and non-commissioned officers, he was not called out or corrected for his misogynistic behavior towards a senior ranking female soldier.

Further, Strength was not rescued, supported, or even comforted after the incident. Strength initially wondered if her command questioned her ability to maintain her bearing and was disappointed in how she reacted to the subordinate soldier who publicly assaulted her, “Were they questioning my military bearing? Maybe they thought I was too vocal . . . too loud, but I was mad. I outranked him and he disrespected me in front of everyone.” Strength felt that her command allowed the subordinate to have power over her because he was Caucasian, and she was Black. Strength was his superior, but she felt as if she was his subordinate because his race gave him power over her.

The next day, when Strength reported to work there was a void in the office, “It was as if the incident never happened. No one said anything to me.” The message that was silently communicated to Strength, by the actions of the women in her unit and superiors, was that she had to act as if nothing had happened, “It was business as usual.” Then, all of a sudden, on the same day, Strength was ordered to take a surprise drug test and allegedly tested positive for cannabis. She was then forced to participate in a substance abuse treatment program and was told that she had to admit to abusing drugs. She refused to admit to something she had not done, “I never used drugs.”

Strength felt insulted and disrespected that she was targeted and falsely accused of using drugs and forced to participate in a drug treatment program. She was also infuriated because there were dental personnel who worked in supply, and in other sections of the

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unit, who were known for abusing nitrous or cannabis. However, none of their drug screens yielded anything suspicious. Strength said that some of those soldiers even appeared to have looked like substance abusers, but they were not singled out and sent to treatment, as Strength was. Yet, Strength allegedly tested positive for marijuana, and she had never used the substance in her life; furthering insult to injury, she never even saw the test results.

During the several weeks of drug abuse treatment therapy, the psychologist tried to force Strength to admit to abusing marijuana. After refusing to admit to something she did not do, Strength was sent back to work as if nothing had happened, “It was business as usual.” Next, she was given a hardship tour to Korea where she could not take her family. Strength was eight months pregnant at the time. Assigning Strength a hardship tour to Korea was surprising and out of the ordinary, because the military would have typically given a pregnant soldier a duty station assignment where she could have taken her family. To Strength, it seemed highly odd to have been given a hardship tour a month before she was going to give birth to her first child. If Strength had accepted the assignment, she would have had only 30 days to bond with her newborn after giving birth before being sent to Korea for a year. Maternity leave was only 30 days when Strength was in the military. It was hard for Strength not to see her command’s actions as anything but vindictive and retaliatory. There seemed to be no other explanation for these actions. She felt betrayed by her command. The retaliatory actions and institutional betrayal also communicated to Strength that her career in the dental program would be ending abruptly, devastating her even more. She had worked tirelessly to prove herself as being one of the best dental technicians in her unit, despite experiencing sexual harassment and

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racism daily before the informal dining event. However, because of her sex and race, being the best was not enough.

Talking about the incident involving the subordinate, her superiors, and the ensuing retaliatory behavior by her command, during the interview for this study, was upsetting and overwhelming for Strength because she had not done anything to warrant such egregious mistreatment. Before the night at the party, Strength had never been in or caused any trouble, she was considered an exemplary soldier and dental technician. It was not until the interview for this study, 30 years after the incident, that she was able to piece together and make sense of her military experience.

During the interview, Strength realized that she had been disregarded and discarded by the Army because she brought attention to her MST incident at the dinner. She also accepted that race discrimination also played a role in how she was retaliated against and betrayed by the Army. Because of the horrendous ordeal she endured by her command, another message was communicated to Strength. The message she received was that the laws, rules, and standards she was forced to learn during basic training about behavior, the chain of command, and respect were not to benefit or protect her. Strength felt that she was not privy to the benefits or protection of the Army’s laws, rules, and standards because she was a woman and an African American. It seemed to Strength that the laws, rules, and standards she learned only applied to her to discipline, control, and to punish her. She felt betrayed by the very institution she swore to serve and protect with her life. She internalized the entire ordeal as a “catastrophic” experience, “It was as if my military service and commitment did not matter to the Army.” Strength also internalized that her

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military service was insignificant in comparison to the perpetrator’s, “I swore to serve and protect this country too, and I had been serving longer.”

Also, during the interview, it was clear that Strength was making some connections that she had not previously made about the sexual assault incident and the series of indignities that occurred after. The retaliatory actions committed by her command were calculated and vindictive in nature, and Strength felt stripped of her power and dignity. The surprise drug test and the false allegation of positive results, the several weeks of forced and abusive substance abuse treatment, and the hardship tour assignment to Korea during her pregnancy all seemed to have been attempts by her superiors to retaliate against her and encourage her to separate from the military. The realization of her superiors’ motives was devastating to accept, “I guess I blocked that ordeal out until now. It is still hard for me to believe that happened to me.”

Strength passionately believes she would have achieved more success, academically and professionally, if she had not experienced MST and institutional betrayal, “The military just shut me down.” As a result of her military trauma experience, she went from being enthusiastic about life to feeling broken, “Just going through the motions . . . just doing what I had to do.” The military taught Strength to accept and become numb to being verbally and sexually harassed, “You learn to shrug it off and keep moving.” She feels as if she was short-changed by the military. Most of what she joined the military to experience had been denied her. According to Strength, the military did more harm than good it took more than it gave. Even though she experienced sexual harassment in the military prior to this incident, this experience was too catastrophic to ignore because her superiors accepted it and did not protect her. Strength experienced MST and racism at

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every base she was assigned, but the most blatant incident occurred in Kansas where she chose to end her military career. Strength survived despite her military experience, but she still has challenges.

Strength, as a nurse at a VA Hospital, encounters many women who share their MST stories with her. Interestingly, she never associated the women’s MST experiences with her own because, “I was not raped.” She did not consider what she endured in the military as MST. She just knew that she felt violated and was treated unfairly. Strength had been numbed to her own MST history, “I guess I had forgotten about it.” Was she numb because that was her way of staying strong so she could function and raise her children? She is just now talking about her trauma experiences. Does Strength experience guilt for joining the military when it was not her only option? She chose to join to pay for school, travel, and serve her country. In the end, she did not receive any of what she joined the military for.

Power.

Power is a Caucasian Navy Veteran, who joined the military to become a linguist. She was 18 when she joined and when she experienced her first MST incident. Shortly after the Tailhook Scandal, the Navy facilitated a mandatory two or three-day sexual harassment training. After the training, Power went out for a drink with a few Navy and Marine buddies she worked with. On their way back to the barracks, one of the Marines slapped Power on the buttocks. Another Marine said, “sexual harassment” and they all laughed. The first Marine kept slapping Power on her butt, and she asked him repeatedly to stop, and he did not. She then turned to face him and told him sternly to stop, and the

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Marine headbutted her. The headbutt broke Power’s nose. The Marine said, “I’m going to kill you bitch.” She ran and the Marine chased her. Power ran to a security personnel, and he filed a report after he walked Power to her room in the barracks. As a result of the report, the Marine was punished for calling Power a “bitch,” but not for his violent behavior towards her (breaking her nose), or for slapping her on the buttocks. Power stated the Marine was punished for calling her a name because of the sexual harassment training, “I guess the military did not figure that violence is a big part of sexual harassment and sexual assault.” After the Marine was punished, his teammates retaliated against Power for getting him in trouble.

A second MST incident occurred after Power went to the Non-commissioned Officer’s Club (NCO) club with a few Marine and Navy friends. She reported drinking too much alcohol and a Marine friend volunteered to walk her back to her dorm room. The last thing Power remembers was putting on her pajamas. The next morning Power woke up to find that she was no longer wearing the bottom of her pajamas, her tampon had been removed, and her vaginal area was sore. She believed she had been raped.

Another MST incident transpired at the NCO club. Power had not been drinking, but the Marine friend she was with had been drinking. The Marine friend asked if he could speak to her outside of the club. Power followed him outside and sat on the curb next to him to talk. Shortly after Power sat next to him, he began grabbing her and forcing her to lie down on the ground. She fought him, but he pinned her down. As the Marine was trying to pull her shorts down, another Marine friend came outside looking for her. When he saw Power pinned down, he apologized and turned to walk away because he thought they were being intimate. Power yelled for help, and the friend stopped a potential rape

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from happening. A month later, the Marine who tried to rape Power outside of the NCO club raped another female sailor. The Marine who saved Power from being raped reported her attempted rape to the military authorities after finding out about the Marine raping the female sailor. Power, and the Marine who saved her, served as prosecution witnesses. However, the case was dropped because the evidence rape kit came up missing.

Power did not seek support from her chain of command for the rape or the attempted rape. She chose not to seek their support because of witnessing first-hand the backlash and retaliation that would have been unleashed towards her. The chain of command’s support would not have only led to backlash and retaliation but also could have caused the loss of her top-secret and sensitive compartmental information (SCI) clearance. Power would have been forced to participate in mental health treatment if she sought her command’s support, which would have resulted in her losing her clearance. Losing her clearance could have potentially caused the abrupt end of her military career as a linguist. Power felt she did not have a choice other than to function as if nothing were wrong in order to survive the “good ole boys’ club” of the military.

Power said she feels worthless because she was consistently mistreated in the military, “I wasn’t valued this confirms that I’m worthless.” She also blames herself for being raped in her sleep, “If I hadn’t drank so much alcohol, I would have been able to stop him.” She joined the military for structure, guidance, and for an opportunity to evolve into a productive and successful member of society. Power’s enlistment in the military instead resulted in her making a series of poor decisions during and after the

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military, which was a direct result of the MST and institutional betrayal Power experienced.

Power described experiencing a “low point” (i.e., frequent partying and excessive drinking) towards the end of her military commitment, “I did not want to be in the military anymore . . . I just wanted out.” She no longer cared about being a linguist. She no longer cared about traveling around the world. Power was able to end her enlistment a few months early and left the military. Although Power had hoped that her military commitment would have resulted in a successful career as a linguist, leading her to an abundance of other opportunities, but the series of MST incidents, and being betrayed by the military, turned a once enthusiastic and intelligent 18-year-old recruit into a jaded and mistrustful young woman. In 1994, Power was 21 when she left the military and became an exotic dancer, “Why would I value myself . . . the military didn’t value me.” She continued what she described as a destructive path for six years until she became pregnant with her daughter. The pregnancy with her daughter renewed her faith in humanity and encouraged her to improve her life situation.

Power began therapy to address her MST history at a local VA in 2018. Bringing her traumatic memories to the forefront of her mind proved to be too overwhelming for her. Power attempted suicide and was hospitalized in 2019. Power believes that her history of poor decisions and self-destructive behavior is directly related to the MST she suffered, and the associated institutional betrayal she experienced. Accordingly, the institutional behavior she and other female MST survivors experienced from the military is a strong indication that women service members are not valued by the military.

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The feelings Power identifies with the most are hopelessness and insignificance.

Power indicated that these feelings were consistently confirmed by the predatory actions by her male peers, and the blatant disregard by her superiors in the military. Her peers and superiors confirmed that her presence in the military was for the sexual fulfillment of the men, and that her body belonged to them. Her ability to speak multiple languages, and choosing to use her talent to serve the country, did not make her as valuable as her male counterparts. Power’s belief that her contributions were not valued by the military led her to making a series of poor decisions, including attempting to commit suicide in 2019. Additionally, every relationship she has attempted has failed and she has difficulty trusting in others. She is unable to experience a full night of sleep because of the nightmares that invade her mind about MST. Power’s self-esteem is greatly damaged and her outlook on life is jaded.

Understanding.

Understanding is Caucasian and a Maine Corps veteran. She grew up in a military and veteran community in the Washington D.C. area, and attended private schools. Even though her father is an Army Vietnam veteran, she was influenced to the join the Marines because her friend’s father and brother were high-ranking officers in the Corps. She joined the Marines because her family was unable to afford to send her to college. The military offered Understanding an opportunity to train for a career, pursue an education, travel, earn respect, make her family proud, serve in the military for 20 years, retire, and begin another career.

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At age 18, she had the next two decades of her life mapped out. Upon graduating from boot camp, Understanding was proud of her accomplishment because Marine Corps training is more complicated and grueling than any other military branch. Historically, very few women complete Marine Corps training, “Females are called unicorns because there are so few of us.” The positive attributes and characteristics she came into the military with were built upon and enhanced by the Marine Corps training. Understanding knew she was a better person with an amazing future ahead of her because now she was a true Marine.

After boot camp, Understanding excelled in her career training classes. She did so well that she was one of the top five students in her class. She was enthusiastic about learning and was ready to answer the instructor’s questions, and he called on her often. She was particularly enthusiastic because the instructor promised the top five trainees with the highest test scores could win a trip to Hawaii. She felt that she would be one of the Marines going to Hawaii.

Close to the end of her career training program, the staff sergeant (the instructor of the program) surprised Understanding in a secluded area as she was walking back to her dorm early one evening. She stopped to acknowledge him, even though she was taken aback by his sudden and unusual presence near her dorm. He abruptly pushed her up against a building and raped her. While the instructor was raping her, Understanding could only think of how embarrassing it would be if someone saw her doing something wrong. The rape was quick from start to finish, “It was as if I questioned myself that it even happened.” Finally, he walked away as if nothing had happened. She was afraid to face her rapist-instructor-sergeant the next day.

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Understanding felt that something was horribly wrong, and she was confused. She began questioning her academic abilities, “I thought the staff sergeant called on me to answer his questions in class because he knew she was smart. I worked hard. I was ahead of everyone in my class.” The rape did not make sense to Understanding because she was supposed to look up to and respect her superior.

The rape triggered Understanding; she began experiencing nightmares about shattering glass falling on her. When Understanding was a child, she witnessed her friend being cut, severely, by glass shards as she ran through a glass door. For several years, she had not thought about the incident until the night of the rape by the person she trusted and respected as her instructor, “He was married and had a child, for God sakes. I am supposed to look up to him.” The next day, Understanding equated returning to the rapist’s classroom to a “walk of shame.” She internalized the rape as something she had caused. Understanding did not know how to function in his class, or even if she wanted to remain in the military. She was ashamed for saying or doing anything that might have encouraged the rape, “Maybe he felt I was showing off . . . but I worked hard to learn the material, and he always called on me to answer his questions.” Understanding also felt humiliated, confused, and worthless. She dreaded being in the rapist’s class for the last couple of weeks of the academic program. She was afraid to face her rapist in each class, who was also her instructor and sergeant. She blamed herself for not stopping the rape, “I should not have answered so many of his questions in class . . . I should not have taken the shortcut behind the dorms.” However, she pushed herself to act as if everything was normal. When the instructor-rapist asked Understanding a question in a taunting manner, she answered, but the enthusiasm was gone.

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In addition to experiencing fear and self-blame because of the rape, Understanding also felt inadequate. Further, her self-esteem and confidence were shattered. The positive attributes and characteristics she developed before and during boot camp were all being questioned and felt nonexistent for Understanding, “Apparently, I’m not a good person if he could just rape me . . . I must not be a good Marine.” Shortly after the rape,

Understanding obtained a boyfriend who had a car and was the same rank as the rapist. The car allowed her opportunities to get away from the base after class, and the boyfriend was her assurance that the instructor would not rape her again.

It became evident to Understanding that the staff sergeant lied about the Hawaii competition trip for being the best student. However, it was not clear why he lied. Understanding wonders if he used a psychological façade to guarantee that the female Marines expressed enthusiasm in his class. She wondered if he used scholarly enthusiasm to become sexually excited. The rape was incomprehensive for Understanding. She blames herself for being an enthusiastic student, “for being eager.” Instead of being sent to Hawaii as promised, the top five Marines were assigned to Charleston, South Carolina.

Understanding was one of the first female Marines ever to have been assigned to the Naval detachment in Charleston. Understanding understood that being the first female at the location would have been pioneering, and she felt honored

Understanding’s boyfriend drove her to the permanent duty station in Charleston. When they arrived at her barracks, over 100 Marines shouted lewd and lascivious comments about Understanding and her body from the windows and doorways. Her boyfriend threw out her baggage and said he could not handle her living in a building with “all of those men.” The boyfriend drove off and left Understanding standing there;

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she was just 19 years old. Understanding feels that her boyfriend must have known that she would eventually be victimized and felt helpless, “Being in the Corps for several years, he knew something would happen to me there was nothing he could do for me.”

She was still standing in front of the barracks in shock when an African American man in civilian clothing walked up and introduced himself. The shouting abruptly stopped. He welcomed her to the unit and walked her to her dorm room door. He stood uncomfortably close to Understanding and told her to let him know if she needed anything. He also said things that made her feel sad, cheap, and dirty. Understanding found out later that day the man was her commanding officer. She also found out the same day that he had chosen her as his sex slave. The commander was African American, in his 30s, and married with children. Understanding had recently turned 19, and had not recovered from the rape she suffered two months prior.

Shortly after Understanding was chosen as the commander’s sex slave, he took her to a car dealership and made her choose a car. She did not know he would force her to choose a car, but she followed his orders. At that time, she was not considering a car, and even if she had wanted to buy a car, she could not afford it. After she chose the car, the commander co-signed for it. Understanding was confused, “Was this his way of convincing her that she was in a relationship with him?” Understanding’s superior officer was the commander, and her military career and future depended upon him. Now she had to depend upon him to help her pay for a car she did not ask for and could not afford on her own. For the commander, the car would be used to chauffeur him around and, for

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Understanding, it became a means to allow her to leave the base and distance herself from her rapist for short periods of time.

The commander openly paraded Understanding amongst the other Marines. The Marines that liked him cheered him on and patted him on the back when Understanding was with him. In the rare moments that Understanding was without the commander, other Marines called her “n-word lover.” She was accused of using her body to excel in the Corps. The accusations resulted from the belief that Understanding was receiving undeserved benefits and recognition. She did not have to share her room with a roommate. The commander paraded her around like she was his prize possession, ceremoniously presented her with a meritorious award for a special duty assignment that she performed exceptionally well, and he promoted her to a higher rank earlier than the other troops.

Although Understanding worked hard on the special assignment and believed that she had earned it, she could not feel good about her achievement. She could not feel good about her achievement because she doubted and looked down on herself because the commander came to her room at will and did whatever he wanted to her. He even took her on business trips and to his hometown. Understanding was also introduced to the commander’s friends and family members in his town. She had no agency, and the commander had total control over her life, career, and future. Understanding could not escape the commander’s sexual advances nor the ridicule of her peers because she was seen as being in a consensual relationship with the commander. Understanding served as the commander’s sex slave for almost two years. The commander could do whatever he wanted to her. Understanding did not have a choice, voice, or autonomy.

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In an attempt to cope, Understanding drank alcohol excessively to deal with being repeatedly victimized and held in captivity. As a result of Understanding’s excessive alcohol abuse, her kidneys shut down, and she had to be hospitalized for several weeks. Therefore, the commander replaced her with another young female Marine. Understanding’s replacement received a private room. Understanding acquired a roommate because she was no longer the commander’s favorite, and she experienced a sense of relief because the commander moved on to someone else.

She immediately found a boyfriend who had a car. Understanding wanted a way to leave the base after work each day to avoid running into the commander. She also chose a boyfriend because he was Caucasian. She reasoned that by having a Caucasian boyfriend, her fellow Marines would stop calling her “n-word lover.” Understanding chose a person she did not particularly care about, “I didn’t even like him that much. I just wanted to get away from the base to make sure the commander couldn’t have access to me.”

Understanding also wanted to distance herself from the ridicule and abusive judgment of the hundreds of male Marines, who were her peers. Her peers referred to her as either lucky because she was the commander’s favorite girlfriend, or an “n-word lover” who was an opportunist.

Understanding was not an opportunist; she was a victim of MST and institutional betrayal. She was trained to follow orders and obey her superiors. Based on the description of her career, she was an honorable Marine. Also, she felt that the institution that she swore to serve and protect did not honor or protect her. The Marine Corps made Understanding feel dirty, broken, and as if she had done something wrong. She was at a

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low point in her life. She blamed herself for being the commander’s favorite. She blamed herself each time he raped her.

During the low point in Understanding’s life, she drank even more alcohol to cope with the abuse she endured in the military. Just when she started to believe that the commander was done with her, she was ordered to testify against him in the military court martial. The commander was on trial for the behavior unbecoming of an officer (e.g., having sex with subordinate female Marines). Shortly after the commander replaced Understanding with a new female Marine subordinate, someone saw them together and reported the commander. Hearing that someone finally reported the inappropriate behavior of the commander when he was seen with the new female Marine was ironic to Understanding. It was ironic for Understanding because the commander openly paraded her around the base and publicly bragged that she belonged to him for almost two years. No one came to Understanding’s rescue, and no one said that his behavior was inappropriate when he was exploiting her. No one reported the commander for being in an improper relationship with his subordinate when he publicly showed her off for almost two years. Understanding was curious “When did his superiors start caring about young female Marines being victimized? I must not have been of any value to the military. They saw me as the villain, and I was only 19 when he started raping me.”

The court martial resulted in the commander being found guilty, and he was sent to prison. Although Understanding testified against the commander, no special services or counseling were provided to her. She was seen as a willing participant and not a victim. However, Understanding was the commander’s sexual slave. He controlled every aspect of her life, career, and future. No one wanted to accept her as a young, honorable Marine

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who joined the military to serve this country. Instead, Understanding was villainized, victimized, and betrayed by dishonorable men in power and the United States Marine Corps. Even though Understanding testified against the commander, it was suggested that she “watch her step” because she helped to take “a good man” down. She was identified as a troublemaker by the new commander. Understanding was alone in a military branch she chose after high school to improve her life possibilities. However, the Marine Corps failed and betrayed her. There was no one she could turn to for help. She went from being enthusiastic about being in the Corps to needing to find a way to get out of the military, “I no longer cared.”

Understanding began breaking the rules while in her alcohol stupor, and she was written up several times. She lost hope for herself and the Marine Corps. She felt betrayed, victimized, ashamed, and alone. Understanding continued to drink copious amounts of alcohol to cope, and she experienced blackouts and made many mistakes, “I was spiraling out of control . . . I lost hope.” She also began smoking cannabis with her boyfriend, whom she married to avoid being sexually exploited by anyone else, and to create a safe distance from the ridicule of her peers. Two days after marrying, Understanding and her new husband were kicked out of the military for smoking cannabis. She received an Other-Than-Honorable (OTH) discharge, making her ineligible to receive services at any VA hospital or facility. Understanding felt as if she failed, “I felt like I was a loser.” She withdrew from the world and fell into a deep depression. She was unable to sleep because she experienced nightmares often. She also could not maintain employment.

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A year after being kicked out of the military, Understanding committed suicide but was brought back to life. She was angry that she was revived. Understanding said, “I wanted to die.” She was hospitalized again after overdosing on cocaine less than a year later. Alcohol and drugs were how she coped with experiencing MST at two bases from age 18 to 21, the institutional betrayal and loss of her military career, and the loveless and abusive marriage she rushed into to avoid subsequent rapes in the Corps. Whenever she was reminded that she had an OTH and was not considered a veteran, Understanding experienced suicidal ideations. She attempted suicide again and was in a coma for a week.

After being out of the military for five years, Understanding could mentally and emotionally sustain somewhat better, and she and her husband had three daughters. However, she was still unable to maintain viable employment. She finally divorced her abusive husband after 13 years of marriage. She married two more times, but the marriages lasted less than six years total. All of her marriages and relationships were abusive. In different relationships, Understanding has had a knife held to her throat, a gun put to her head, and was raped again. When the police responded to a domestic disturbance call, they found a noose hanging around Understanding’s neck.

In addition to relationship and employment problems and a history of domestic violence, Understanding has been psychiatrically admitted several times and received a variety of diagnoses. Because of her OTH discharge, she did not attempt to seek services at the VA Hospital. As a result, she was unaware of being eligible to receive VA services to address her MST, regardless of the quality of her discharge. In 2021, Understanding reviewed the VA.gov website for the first time, and that is when she first learned about

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MST. She also learned that what she endured in the Marines in the 1980s fell under an overwhelmingly clear definition of MST, and this realization caused Understanding to become suicidal. She immediately called the Veterans’ Suicide Hotline several times and eventually found out that she could possibly receive treatment at the VA for MST-related concerns.

The VA provided two virtual counseling sessions after a 30-day waiting period. However, Understanding was not allowed to talk about her trauma history during the sessions. Instead, she received two psychiatric appointments to determine her need for medication and a two-week hospital stay at a civilian institution to address her suicidal ideations. Unfortunately, her car and gardening tools, which provided a way for her to work as a gardener, were stolen from the hospital parking lot where she was admitted. The theft of Understanding’s car and gardening tools caused her to become homeless because she was unable to work. Because of Understanding’s OTH discharge, the VA did not provide further treatment or services.

Since 2021, having come to the realization that she was once a healthy and vibrant person before being sexually exploited and victimized in the Corps, Understanding has been in a constant and arduous battle with the VA to receive treatment and benefits. She has been in the throes of battle with the VA despite the ongoing and insurmountable problems (i.e., suicidal ideation, homelessness, revictimization, and substance addiction) that she has been juggling on her own since being kicked out of the Corps. Understanding views herself as broken beyond repair by MST. The residual effects of her MST experience are exhausting for her. Understanding feels exhausted because she must relive the once-buried memories of the victimization and betrayal she suffered in the Corps

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every time she tells her trauma story to a new VA gatekeeper to qualify and receive services for MST.

Fighting for VA services for over a year has kept Understanding’s trauma memories up close and personal in her conscious mind. The violations and injustices she endured frequently invade her mind during the day and haunt her at night in her dreams.

Understanding cannot rest or experience peace, and thoughts of not wanting to exist often plague her total being. There are also constant thoughts of dread that race through her mind, and depression and anxiety have been her most common emotions.

Understanding has not enjoyed sex her entire adult life, she has had three failed marriages, and every intimate relationship she attempts quickly fails. She often feels on edge and jumpy. Understanding is just a shadow of the 18-year-young woman she once was (i.e., physically, mentally, and emotionally healthy, vibrant and hopeful) before the start of the MST. She is currently homeless, her daughters have distanced themselves from her, and she has been abusing drugs to mask her pain. Understanding is trying not to give up hope, but she feels broken beyond repair.

Although she recently read that her MST history was not her fault, she continues to blame herself. Understanding mainly blames herself because of the way her superiors mistreated her in the Corps and for receiving the OTH discharge: I just don’t know what it’s like to feel safe anywhere, even with people that have given me no reason to fear them. I have not been anywhere in public without being super paranoid that something is going to happen to me, or who’s looking at me and what they think. Now I have angry outbursts at the slightest things. I’m really angry that what those men did to me 37 years ago

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drastically changed the course of my life. I never had a chance to be an adult before that happened. I have run from anyone trying to get close to me. My three daughters have given up on me I don’t blame them, they’ve seen many men abuse me, and I’ve abused myself. I feel like my freedom was robbed from me, along with my dignity and self-confidence. I have gotten so bad that I made some really bad decisions lately that have resulted in me being homeless.

Understanding still feels the way she had over 37 years ago when she was being victimized throughout most of her military service. She often feels broken, alone, worthless, humiliated, and she also experiences anxiety almost daily. Understanding holds on to what was drilled into her brain while serving in the Corps, “Marines are the best of the best and of the highest caliber in the nation.” Understanding was told to hold her head up high because she is a Marine, but she has not been able to hold her head in over 37 years. Determination.

Like the other interviews, the interview with Determination was conducted in Zoom. However, unlike the other interviews, Determination made it difficult to see her face. She did not shut off the camera; she positioned her face such that the sun shone directly on it, and it was only possible to see a figure. She was aware that she was obscuring her face because she could see the image that she was presenting in Zoom. It seemed as if she was experiencing shame. I reminded her that she had the option to shut off the camera and terminate the interview at any time, and Determination said she was fine.

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Determination is an African American Army veteran. She was optimistic and enthusiastic when she decided to join the military at age 19 to become a registered nurse. Training as a nurse in the military was imagined by Determination as an opportunity to grow into the best person she could become. She also imagined that she would travel, have fun, and receive education and training. Determination had expectations of becoming successful after leaving the military.

She successfully completed basic and advanced military training. Determination also, successfully, worked at her permanent duty station as an operating room technician (OR tech) for over a year at Fort Lewis Washington before encountering MST. She was an impressive 19-year-old surgical nurse in training whom the surgeons respected. She said she was the preferred nurse to assist the surgeons in challenging surgeries.

Every day after work, Determination was confined to the base because she did not have a car or know how to drive, so she purchased a car. A sergeant in her unit, who was in his mid-to-late-30s and an OR tech nurse, offered to teach Determination how to drive. The sergeant took Determination driving many times. On one particular day, after a driving lesson, they purchased some food and returned to the barracks. They went to the sergeant’s room to separate their meals, and Determination was going to take her food to her room. As she walked towards the door, the sergeant grabbed her from behind. He picked her up and threw her across the room onto his bed.

At first, Determination thought the sergeant was playing, but quickly realized that he was not. He looked at her hands and said, “These hands.” Determination had no idea what the sergeant meant. Then he suddenly became filled with rage. The sergeant’s intensity and rage paralyzed Determination. She was 19 and afraid, and she could not

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believe what was happening to her by someone she trusted. During the rape, Determination was dismayed. Her mind could not comprehend what was happening to her, “It happened so fast; I could not think. The rage in his eyes. I was scared to pieces. I kept saying no.” As soon as the assault began, it ended. She grabbed her clothes and shakingly ran to her dorm room. Determination showered and cried. She said to herself,

Wash yourself, wash yourself, wash yourself . . . my mind was in a whirlwind. I was frantic. I was petrified. I didn’t know what to do. I couldn’t believe what just had taken place. I didn’t see it coming. I can still see the rage and the evilness in his eyes.

Once she was able to compose herself, she called her sister. Determination became hysterical while trying to talk to her sister. It took Determination a long time to tell her sister what happened because she could not stop crying long enough to speak clearly. After revealing the ordeal to her sister, Determination never again discussed the MST until the interview. She felt she could not report him because no one would believe her over him. He was an established sergeant at the hospital, “He looked outstanding and was always pristine in his uniform.” Determination also blamed herself for the rape because she asked him to teach her how to drive, “No one is going to believe I did not ask for that.” In an effort to stay safe, she planned how she would avoid seeing or being around the rapist at work, on the base, and in the barracks.

Determination tried to suppress the rape, move forward in her life and military career, and avoid the rapist. She would review and make changes to the work schedule to ensure she did not work the same shift or would be in the same clinic as the rapist. A couple of months later, she began experiencing nausea daily. The surgeon she worked

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consistently with recommended that Determination takes a pregnancy test. Determination was shocked and insulted by the surgeon’s recommendation. Then instantaneously, the rape incident came rushing to the forefront of her mind, and she became besieged with feelings of dread. The surgeon noticed the terror on Determination’s face, “I was shocked. I almost fainted.” He instructed her to return to the hospital after hours so he could scan her uterus for a fetus.

After dark, she returned to the hospital for the pregnancy scan. The surgeon confirmed that she was not only pregnant, but she was pregnant with twin boys. During the interview, Determination was asked if she told the surgeon about the rape and said she could not remember. However, the surgeon actions, helping Determination take a pregnancy test after work, performing the scan himself, and authorizing her to have an abortion, were all indications that he might have been aware she was in distress. The surgeon seemed caring and accommodating to Determination, and he helped her to conceal her pregnancy and the termination. However, there is no way to confirm if the surgeon knew Determination’s particular set of circumstances.

Once again, Determination became an emotional wreck. She was hysterical when she called her sister and tried to talk to her. She could not stop crying and shaking. She told herself she could not keep that “monster’s kids.” As a result, Determination made a decision that continues to haunt her and cause her emotional distress. She had an abortion, “I did not have a choice.” It took some time for her to bury the memories of the rape and abortion within the deepest crevices of her mind so she could try to function at work.

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It seemed as if Determination had found a successful way to exist and function for a while. It helped that she continued to work different shifts to avoid the rapist. Sometime later, Determination was assisting a plastic surgeon in performing an implant surgery when the rapist abruptly walked into the surgery room and stood by the door with a smirk on his face. He was not supposed to have been there. Determination started to shake, “I became discombobulated . . . unglued.” She accidentally damaged the implant, and the surgeon began yelling at her and made her leave the operating room, “I felt reduced to nothing.”

Throughout Determination’s tenure as an OR tech, she had never made any mistakes while assisting the surgeons prior to the implant surgery. Even after the rape, she maintained her composure and professionalism in the operating room. She was considered an exemplary nurse whom the surgeons preferred to assist in their work. Determination had assisted in various challenging surgeries, and she was being prepared to assist in brain and heart surgeries, which she was excited about performing. However, her commanding officer transferred her to the general practice clinic after the incident.

Although Determination would have preferred to have stayed in the surgery department, the transfer allowed her to distance herself from the rapist in that department.

The accident during the implant surgery caused her to rethink her career path in the military. Determination was concerned about the rapist interrupting another one of her surgeries again and the possibility of her causing harm to a patient because she overreacted. Therefore, she left the surgery department willingly and chose to work in the general practice clinic to avoid her rapist.

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She spent the remainder of her two-year tour working in the general practice department and skillfully avoiding the rapist. Then, just when she thought her efforts were keeping her safe, both emotionally and physically, the rapist was transferred to her department. When Determination saw him in her clinic, she began to spiral out of control mentally and emotionally. Then, when she was trying to figure out what she could do to stay away from him, she received orders for her new duty assignment in Germany. That same day, Determination asked her superior to allow her to immediately begin her vacation and travel leave early to prepare for the move to Germany and to visit her family.

During the interview, Determination remembered an incident that occurred before she was assaulted. She recalled a moment when she walked past a female soldier who she initially thought was staring at her. Determination quickly realized that the soldier was not glaring at her but the person behind her. The sergeant who worked with Determination was the person the female soldier was glaring at with venom in her eyes. He was the sergeant who would later assault Determination. In hindsight, Determination believes that the incident when the female soldier glared at the sergeant-rapist with such a venomous expression filled with sheer hatred was because he raped her too,

I bet he did to her what he later did to me. There is no other way to explain the chilling look she gave him. There was nothing but hatred in her eyes. If looks could kill, he would be dead.

It has been close to 30 years since she experienced MST, and Determination still has nightmares about the incident. She continues to experience horror and guilt for the rape and resulting pregnancy, and the dreaded abortion she was firmly against, “I didn’t have a

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choice.” She internalized all that went wrong in the military. She feels guilty and ashamed of her MST experience because she chose to join the military, wanted to learn how to drive, and for allowing the rapist to be her teacher.

Determination also internalized the guilt and shame for aborting her twin sons and making a mistake during the transplant surgery. However, all the trauma she has internalized from her military experience is tied to the once trusted sergeant who raped her. The internalization also includes the mistake Determination made in the surgical room. The implant surgery, something she had assisted in multiple times, was going perfectly until the rapist abruptly walked into the room. A revelation surfaced during the interview about the reasoning behind the rapist walking in during the surgery to intimidate Determination. Taking into account the impeccable reputation she had amongst the surgeons and the statement the sergeant made about Determination’s hands during the rape (i.e., “These hands”), it seems as if the rapist wanted to destroy her on multiple levels. It was not enough that he annihilated her psychological well-being by betraying her trust and sexually violating her; he tried to destroy her as an astute operating room technician who had a promising medical future.

As a result of the MST, Determination left the operating room and never returned. Each time she attempted to obtain her long-term dream of becoming a registered nurse, something always interfered. Despite this, Determination achieved a certain level of professional success after leaving the Army. She works in the VA as a nurse in general practice. However, she feels that there was more she would have liked to have achieved. Further, she experiences a debilitating sense of loss and remorse for the twin boys. Determination carries this loss and remorse as she raises her living children by being

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overly protective of them. Her relationship with her husband suffers because intimacy is a challenge for Determination. If she is not with her family, she often self-isolates. Poor self-esteem, experiencing an inability to rest, and frequently dealing with feelings of dread and inadequacy are constant for her. Determination’s MST experience has changed and grossly affected several aspects of her life.

Wisdom.

Wisdom is a Caucasian Army veteran. She received a scholarship to attend college, but she could not afford to pay for the room and board. So, she chose to join the Army at age 18 to secure financial support to pay for college. She also wanted to get away from home, explore the world, and serve the country. Further, Wisdom wanted to experience other cultures, become financially independent, and have full medical benefits. She imagined that being in the military would be fun working as part of a team, and that she would have close relationships with like-minded people who are serving the country. She went to basic and advanced training in Georgia. After the training, she was sent to Hawaii as her first duty station in 2000. In 2001 Wisdom deployed to Iraq, and in 2003 she was stationed in Colorado.

Wisdom’s first MST experienced occurred during the first week of basic training. She was instructed to run into a building and obtain some equipment. Once inside, Wisdom bent down to tie her shoe and a male recruit grabbed her buttocks. The first thing she thought, “Why did I bend over that way. It was a completely inappropriate way to bend over.” Wisdom ruminated about her alleged actions and blamed herself throughout the intensive training.

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On the day that Wisdom completed the 10-week advanced training after basic, she joined her fellow trainees and military instructors at the bowling alley on the base to celebrate. The instructors asked Wisdom and some of her follow female trainees to go home with them and have sex. She and the other trainees collectively refused the instructors. Wisdom felt empowered by the collective strength and support she and the others exhibited.

When Wisdom arrived at her permanent duty station in Hawaii in 2000, she worked constantly while living and working in the woods for a year with the 25th Infantry Division. The 25th Infantry Division trained in the woods of Hawaii in preparation for war-like situations. She was constantly added to the schedule to work additional hours because she was a radio operator, “I was good at my job.”

Wisdom was excessively sexually harassed on the job by one sergeant. He harassed Wisdom so often that she became numb to his efforts and those of the other men who also harassed her. On one occasion, Wisdom attended a party at the sergeant’s house with some of her co-workers. There were several other people at the party when they arrived. Wisdom remembers consuming half of her drink before she felt strange and began going in and out of consciousness. When she realized that something was terribly wrong, she tried to leave and found the house was empty, “Everyone was gone.”

The sergeant pulled her to a bedroom and placed her on a bed. Wisdom was groggy and did not have control of her body. As he raped her, she was not able to move, “I couldn’t move my body at all.” Wisdom was 19 years old when this incident occurred. The next day at work, Wisdom tried to confront the sergeant about drugging and raping her, but he avoided her. He avoided Wisdom for several weeks. Subsequently, the

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sergeant began sexually harassing her again until she transferred to another a new duty station in 2003. The sergeant harassed her daily at work, “He made my life miserable,” for the next few years. Because of the rape, going to and from her barracks was a wellplanned mission in which Wisdom strategically ensured she was not being followed, and she was purposeful about locking all of the locks on her door.

The harassment continued for so long that the sergeant’s behavior became blatant and very public. At one point, Wisdom was frustrated by his continued harassment and threatened to tell everyone what he did to her. She loudly told the sergeant to “Leave me the fuck alone or I will tell everyone what you did to me,” in front of everyone in the workplace. Wisdom said she could not take his harassment anymore. Although Wisdom’s public rebuke was effective in getting the sergeant to stop harassing her, he had friends in the workplace who were complacent and retaliatory. The friends also made sexualized comments to and about Wisdom; they also talked about their conquests with other young female soldiers.

Wisdom reluctantly attended another house party with her coworkers and the sergeant who raped her was also there. Wisdom noticed how the sergeant had been following and offering drinks to a new female soldier who was around the same age Wisdom was when he raped her. The younger soldier fell asleep on the couch and Wisdom immediately stood next to her, “I hovered over her like a goddamn helicopter.” He asked me what I thought I was doing, “What is your problem.” She told the sergeant, “You need to leave her the fuck alone.” Wisdom sat next to the sleeping female soldier the entire night. The sergeant finally left. Wisdom believes that the sergeant used ketamine on her when he raped her. She also believed that he put ketamine in the drinks

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of several other women before he raped them. During the time of this incident, Wisdom was 21 years old. She said she did not care how she appeared anymore.

As mentioned earlier, the sergeant was not the only person who harassed Wisdom in Hawaii. Wisdom was constantly being sexually harassed on the job and where she lived. The sexual harassment was relentless. Wisdom could not even eat a meal in the chow hall without a soldier telling her how he was going to “rock her world.” The men who harassed her in the chow hall, included her superiors in rank and age; men she was supposed to looked up to on the job. They would search for and find her in the chow hall during breakfast, lunch, and dinner begging her for sex. The same superiors came to her barracks’ room door. She would open the door and find them fully erect or with an exposed penis, and begging to be allowed into her room, “I still have nightmares of being chased by all those penises.” Wisdom managed to refuse entry into her room. Wisdom’s superiors were married but when then they came to the barracks, they referred to themselves as “geographical bachelors.” The superiors referred to themselves as such because their wives were back in the mainland, and they considered themselves as single while being stationed in Hawaii. After two years of being stationed in Hawaii, Wisdom became depressed because she accepted the reality that many of her fellow soldiers and superiors only saw women soldiers as sex objects.

Wisdom began dating someone higher ranking than her hoping to stop the harassment. After marrying Wisdom, he quickly became both Wisdom’s protector and abuser. Her husband was abusive mentally. Wisdom suffered psychological scars. The severity of the abuse by her husband, the ongoing sexual harassment where she lived and worked, and the flashbacks and nightmares about the rape caused Wisdom to emotionally

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and mentally spiral out of control. She attempted suicide and had to be medically evacuated.

Wisdom loved what the military represented. She loved the work she performed and the military, even the work she did in the combat zone. Wisdom would have remained in the military longer, but the sexual assault and the ongoing harassment motivated her decision to leave the military. She feels she would have made other choices if the assault and harassment did not occur. During the interview, Wisdom recalled a close friend whom she served with in Hawaii who is currently preparing to retire from the Army. Her friend experienced a tremendous number of MST incidents throughout her entire military career, starting at age 18.

Wisdom suggests that MST is embedded in the military culture. Therefore, women who serve have had to accept these “hazards” in order to stay in the military; “I don’t know that you can even serve without experiencing some form of MST. It’s a hazard. When you join, you accept the hazard that you will absolutely be sexually harassed by one of your peers.”

While working for the VA, Wisdom’s male veteran clients tried to convince her that not all men harass women, “like in the military.” But for Wisdom, even men who did not serve in the military harass or have harassed women. As a direct consequence of her MST experience, she has lost her ability trust, and she has definitely lost her ability to trust all men. Wisdom is under 40-years old, and she has been in abusive marriages and has divorced twice. Wisdom stated that MST has impacted her ability to trust men and to emotionally connect to them. MST has impacted her relationships with her husbands, and anyone she has attempted to be intimate with, “I don’t think there are many men I can

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trust.” Also, because of the MST experience, Wisdom is hypervigilant about staying in control and safe to the point that it borders on the edge of her seeming neurotic. She is cautious about what she drinks and avoids putting herself in high-risk situations. She is also very protective of her children.

Wisdom also struggles with her appearance, which is connected to the shame and self-condemnation that are intertwined with the thoughts and feelings she has internalized because of her MST history. Seeming too feminine, or appearing too appealing, is anxiety provoking for Wisdom because of the attention it brings. She fears the attention brought on by her appearance because of the sexual harassment she endured in the military. She recalled when she first arrived in Hawaii, and she wore her uniform skirt suit. Wisdom road to her new duty station along with the other new soldiers who just arrived in Hawaii. Wisdom was the only female on the bus, and all of the men repeatedly commented about her skirt, “sexy skirt.” She blamed herself for the attention she received in 2000, and she continues to blame herself today “I should not have worn the skirt, I should have worn slacks.” As a consequence of the shame and self-condemnation she internalized, Wisdom tends to downplay her appearance and femininity, “I very much minimize any kind of femininity because of the background noise you don’t want to put yourself out there.”

Years after leaving the military, Wisdom blamed herself for drinking the tainted beverage the sergeant gave her when she was 18, “This is the older me judging the younger me.” She believed she should have known that there was a substance in the drink that would have caused her to lose control of her body. This belief system has caused Wisdom to wish she had joined a different branch of the military, but not for being in the military. She also feels that someone should have warned her about the rape and

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misogynistic culture in the military; she would have been more prepared and made other choices to remain safe. She wishes someone would have told her that she could be drugged and raped, and then endure daily sexual harassment and retaliation. Because of her experiences, Wisdom said she would not encourage another young woman to join the military. Wisdom blames the rape and misogynistic culture for the necessity of having female soldiers assigned battle buddies while deployed. According to Wisdom, the presence of a battle buddy is supposed to curtail the occurrences of MST and keep women safe. In her opinion, the military applies more efforts in identifying what women in the military can do to stay safe, but they apply less effort in telling men “To not assault women soldiers.”

Wisdom credits the female soldiers she worked with, and those who mentored her, for the positive experiences she had in the Army, “Those women helped shaped me.” She also appreciates three male soldiers she served with who were also positive influences for her. She continues to stay in contact with the three men. According to Wisdom, her military service encouraged her to become a social worker. As a licensed social worker, she worked for the VA for several years helping veterans who are diagnosed with PTSD caused by their combat experience or MST

Love.

Love, an African American, served in the Army for a brief period of time. Her father, brothers, nephews, and uncles served in the military, and she was influenced to join the Army after graduating from high school at age 18. She imagined that the military would mold her into what she grew up witnessing the men in her family exhibited, “Men

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who exhibited love and respect for the country, honor, strength, courage, and discipline.”

Love began her military career in basic training in South Carolina.

During the fifth week of basic training, Love was diagnosed with a heart condition. She was immediately removed from training and placed on a medical hold. It was quickly determined that Love was no longer fit to remain in the military. Just as she had to go through a long and complicated process to be indoctrinated into the military, Love had to go through an even longer and arduous process to become a civilian again. The outprocessing took months and she had to work in an office while she waited to leave. The process was finally completed shy of the six months required to achieve veteran status in the military. This means that Love would not qualify to be a veteran and would not be eligible to receive VA benefits she would need to address the MST she eventually experienced.

During the few months it took to out-process Love from the military, the sergeant who was in charge raped her daily. The assaults occurred around noon each day while the other recruits, who were also being transitioned out of the military, would be at lunch.

Although Love tried to find a place to hide from him each day, the sergeant would find her wherever she attempted to hide and forced her to do whatever he wanted. No part of her body belonged to her during the out-processing period. Each night, she would have nightmares of what she endured earlier in the day. She eventually realized that other female recruits would walk towards the sergeant’s private room too, but after dinner every night. Love always wondered if the other females were being assaulted by the other sergeants who utilized the same private quarters as the sergeant who assaulted her.

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Initially during the interview, she downplayed the frequency of and the number of assaults she endured. The shame and guilt she internalized was apparent.

Some of Love’s fellow recruits noticed that her disposition had drastically changed and wanted to know why. Love told them she was sad about being processed out of the military against her will. However, she was actually angry about the MST she was forced to endure and the lack of control she had over her body. Of course, there were regrets for Love having to be transitioned out of the military. She definitely wanted to complete her training and remain in the military, however the loss of her military career in addition to the MST made the last several weeks of her military experience unbearable.

According to Love, the sergeant violently violated her, and he had total control. He gave her commands, “Move, turn it was horrible. What he did to me was rape. I didn’t give him permission . . . I couldn’t say no.” After each assault, the sergeant pretended it was business as usual. Love was the recruit, and he was in charge of her total being. There was no one Love could turn to or reveal what was happening to her. Even after being medically transitioned out of the military, she kept her MST history a secret until 2012, at which time Love told her mother and another relative about the trauma she endured in the military. But this was years after Love suffered domestic violence, underemployment, and homelessness. After years of diligently working to improve her life circumstance, she finally sought help in 2019 from the VA for her MST history.

Love stated that after she began receiving mental health treatment for her MST experience, she finally felt helped and relieved, “I’m not ashamed; I feel empowered.” She has encountered several other female MST survivors who have told her their stories, and many of their stories sound similar to hers. Because of hearing the stories of other

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women veteran survivors, Love recently realized that she was not alone, “I thought I was alone all these years.” Although the MST experience still feels horrible to Love, she wants to encourage other women to talk about their trauma experience. She feels empowered knowing that there are other survivors, “We share the same horrible past. We can survive together.” Love has built her entire career around helping to house homeless veterans, and helping others purchase their first home. She feels that what she does to help others helps her heal. Although Love has gone to great lengths to help other female veterans, she still struggles with an inability to rest and hypervigilance, severe anxiety, paranoia, and poor self-esteem.

She also struggles with maintaining professional and social relationships, because of her tendency to be overbearing and manipulative. Love’s use of maladaptive coping strategies is due to the need to prove herself worthy, even though she has been successful in several business ventures. Love does not feel worthy because the military destroyed her ambition of becoming a soldier. The medical condition she was diagnosed with during basic training has never been verified, although she spent a lifetime going to several doctors for verification. Therefore, Love feels a sense of betrayal done to her by the military, “They put me out and I was not sick. Now, I am not even considered a veteran because of not serving enough time.” Faith.

Faith, an African American, grew-up in a veterans’ retirement community because her father had served in the military. She attended a private boarding school on the east coast that had a Junior Reserve Officer Training Corps (JROTC) program, which she

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participated in for six years, from sixth to the twelfth grade. Because of her father’s military history and her participation in JROTC, Faith joined the Army at age 21. She imagined her experience in the Army would be similar to what she experienced in JROTC along with including opportunities to travel, have structure, receive an education, and meet new people.

Her MST experience began at the recruiting station when the recruiters sexually harassed her. The sexual harassment continued throughout her basic training. The drill sergeants tried to pressure (e.g., threats of additional chores and exercises, dishonorable discharge, etc.) Faith and her fellow recruits to perform sexual favors, but she did not relent. Even with having to endure the almost daily sexual harassment, Faith not only completed basic training, but she also rose through the ranks to become a high-ranking warrant officer and served in a combat setting in Iraq.

During Faith’s combat deployment in Iraq, the simple function of using the bathroom created hazardous challenges for her. Due to the high number of sexual assaults, the women had to have a battle buddy go to the bathroom and anyplace else that was considered secluded on the camp. The purpose of battle buddies was to ensure that service women were not alone when they walked around the camp. However, at night, Faith would not be able to use the bathroom because her battle buddy would be asleep. There were other times she would be unable to use the bathroom because her battle buddy was not available, or there were no facilities to accommodate women soldiers. As a result, she is currently being treated for medical challenges directly related to her not being able to regularly use the bathroom.

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While stationed in Ohio, at a combat support hospital, Faith’s supervisor sexually harassed her for a long period of time. Even though Faith experienced some form of sexual harassment throughout her military career, the misogynistic and rape acceptance culture and climate in the military caused her to become numb to the harassment. Nevertheless, she became furious because her supervisor’s behavior became more blatant and aggressive each day. She finally found the courage to report him.

Faith reported the harassment to a female supervisor who worked in a different area. Faith was removed from her unit, and she was transferred to a different recruiting station. She experienced a sense of power and control when the female supervisor took action on her report and had Faith’s supervisor investigated. Even though the allegation was substantiated, Faith’s supervisor was given a letter of reprimand for sexually harassing Faith. She felt that the written reprimand was a mere “slap on the wrist,” and she was never allowed to return to her unit. Faith felt that not being able to return to the job that she performed exceptionally well was unfair when her perpetrator remained. She wishes she had protested the command’s decision to remove her from the unit, “If anyone should have moved, it should have been him.” The initial sense of power and control Faith felt when her command first acted upon the allegation was quickly faded after the supervisor was not acutely punished, and she was the one forced to relocate to a new building.

Years later, Faith transferred to a different permanent duty station. The sergeant who was found guilty of sexually harassing Faith, soon transferred to the same duty station as her. His office was across the bridge from Faith’s work location. She informed her first sergeant about the investigation and the reprimand, but she was told that there was nothing that could be done. The only relief Faith had was that her former supervisor was

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not in her chain of command, and his office was further away from her. The distance helped her feel somewhat safe. However, Faith was disappointed that the former supervisor did not receive a real punishment. He remained in the Army and a supervisor, and the reprimand was removed from his personnel file after six months. She also occasionally saw her perpetrator around the base. Further, he was free to potentially sexually harass other female soldiers within his chain of command. Faith still wishes she could have done more. Her inability to have been more effective in having the sergeant receive a more suitable punishment has caused her to be disappointed in the military.

Faith is proud of her military service, the work she performed, and serving in the war. But intertwined with the pride she has for her military service is disappointment and regret. Faith feels as if she was violated by the military throughout her career by having to hear the soldiers’ sexualized jokes and men aggressively asking to go out with her and other female soldiers, I did not go into the military for that! I went in because my father who served in the Korean War, and he never talked about military sexual trauma. I went to a military boarding school, and I did not experience any of that.

The sexual harassment was constant, and Faith learned to be cautious of the intentions of all men. In addition to being suspicious of the intentions of men, it is difficult for her to trust anyone. It is also challenging to see her self-worth.

Faith also has some regrets. She regrets not being able to experience a supportive and family-like environment she heard her father talk about experiencing when he was in the military, and what she experienced in the military boarding school she attended. Her experience of being on guard and protecting herself from the men she swore to fight

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alongside with in war and to protect them with her own life, has caused her a great deal of resentment and confusion. She is resentful because she feels that the military values the contributions of male service soldiers over that of the females. Just like male soldiers, Faith was willing to die in service to this country. She is confused because the military has had the power for the last 40 years to bring MST to an abrupt end, and yet it has not.

Faith’s military experience was complicated. She had many experiences that gave her a sense of accomplishment, but the constant sexual harassment led her to internalize the negative experiences. Her military service has been overshadowed by MST, the rape acceptance culture and climate, and the institutional betrayal. Faith’s military experience has caused her to diligently work on her thoughts and feelings of her service, because of the negativity she internalized. Along with participating in therapy, she has completed a master’s degree in Divinity and published a book on her positive military accomplishments, and those of other veteran women. But Faith did not mention her MST experience. The training in theology has helped Faith to try to make sense of some of what she endured in the miliary, and to accept that her contributions in the military mattered and were significant. She is still on the journey of trying to heal from the MST and the institutional betrayal she suffered. Faith is an Iraq Combat Veteran and MST survivor.

For the participants of this study, MST violations within the ranks represent a threat to good order and discipline and undermines the command structure. It also reduces the retention rate of women in the military. The violations also contribute to the life-long physical, psychological, relational consequences associated with MST.

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Study Results and Themes

The results of this research study can be distilled into six themes after analyzing the 16 interviews from eight female participants who experienced MST. Each participant’s description of their internalized trauma from the military is unique to them; however, this chapter offers a synopsis of the responses representing a collective voice of all the participants. In this section, the six core themes will be identified and discussed. The first theme, “enthusiastically joined the military for a better life,” focuses on how the women joined the military to improve their opportunities in life and their underlying enthusiasm to serve the country. The second theme, “basic or boot camp training where the contract and indoctrination begins,” addresses the contractual commitment of joining the military and the recruit training where the military way of life begins. The third theme, “government property Man’s property, ” suggests women service members are not only considered government property, but also property of the men in the military. The fourth theme, “the dehumanizing effects of MST–THOT,” focuses on how the participants felt devalued and degraded as a result of their MST experience. This degradation is emphasized by the use of the colloquial label “THOT” (that hoe over there), which symbolizes a belief system that is strengthened and calcified by the misogynistic and rape acceptance culture and climate that exists in the military. The fifth theme, “the thrill is gone–broken,” addresses the loss of the enthusiasm to serve in the military. The final theme, “willful ignorance on the part of the DoD,” refers to the DoD’s willingness to turn a blind eye to the continuation of MST, and the rape acceptance culture and climate, 40 years after MST became a crime.

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Theme 1: Enthusiastically joined the military for a better life.

The participants’ decision to join the military was based on their desire to improve their life situation. They believed that the military would provide opportunities and resources, from a career and payment for college to medical insurance and opportunities to travel, that they would not have otherwise experienced if they had not joined. The participants were filled with hope and enthusiasm for the possibility of joining and serving in the largest organization in the world and becoming a part of something bigger than they ever imagined possible, the United States military. Additionally, the successful completion of a military commitment meant jobs, careers, and other opportunities would be available to them in post military life.

Their enthusiasm was further based on their awareness that only a select few men and women (one percent) of the nation’s general population are eligible to join the military, and even less complete the rigorous indoctrination training (Creative Commons, 2020). As women, the percentage who are eligible to join and complete the training is even lower. The women who participated in this study are part of a special population. This population is special because these women were not only a part of the select few who were eligible to join the male-dominated organization that is present in all countries in the world, they chose to sign on the dotted line and pledge their service to the country. They signed and pledged their commitment to serve the military, understanding that it included the potential of dying in service for the country.

Even though some of the participants were also influenced to join the military by hearing the stories from their male relatives who had once served, the participants were all the first females in their immediate and extended families to serve in the military. The

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idea of them being the first females in their families, and often in their communities, is another reason female veterans are considered a special population. During the interview with Understanding, it was learned that female Marines are called “unicorns” because so few can complete the rigorous training. After Understanding successfully completed boot camp training, she described it as being one of her greatest accomplishments, and is still proud of and holds it dear. The other participants also described their recruit training as challenging but rewarding. Furthermore, they all reported still being enthusiastic about the idea of serving in the military despite the challenges they endured.

Theme 2: Basic and boot camp training where the contract and indoctrination begins.

As previously discussed, joining the military is an all-encompassing commitment. Service members become acutely aware, during the initial stages of the indoctrination training, of the consequence of failing to complete their sworn oath of commitment to the military. They understand that failing to complete their military commitment will have severe repercussions for the rest of their lives. Therefore, the women who participated in this study were completely powerless against the perpetrators who abused their authority because they were representatives of the military institution.

The participants’ sense of powerlessness caused by the military contract and the rigorous indoctrination training (removing old bad civilian habits and instilling new patriotic ones) increased their vulnerability to the abuse committed by empowered perpetrators. The perpetrators were empowered by the same tools (indoctrination, rules, regulations, and standards) that were used to reconstruct the participants into battle-ready

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service members at the beginning of their military career (Fairweather, 2019; Lofgreen, 2017).

Theme 3: Government property Man’s property.

On the first day of basic or boot camp training, recruits learn quickly that their total being (mind and body) belongs to the military, 24-hours a day and 7 days week (Lofgreen, 2017). Each participant was told by their drill sergeants that they were “government property” on their first day of training. They were reminded daily, by the drill sergeants, of the commitment contract they signed before they swore to serve and protect the country. This commitment included accepting and understanding that being injured or killed in service for the United States government are distinct possibilities. The participants also learned quickly that they would be held accountable for any actions causing harm to themselves and other military members. Their responsibility to avoid intentional and reckless harm to themselves and other military members is found in the UMCJ, Article 134, Section(a), Reckless Endangerment.

Given the circumstances, the participants accepted that they were the property of the government for the duration of their contract. Imagination said, “I knew I could be hurt or killed, I signed the contract. But I had no idea the men would try to rape me . . . and the harassment was constant.” The participants in this study were fully aware of their commitment and contractual obligation and responsibility to the military. Even though they did not object to the seriousness of the commitment to the military or the idea that they belonged to the military, they did object to being treated like the property of men. They felt that the men believed they had a right to the bodies of the women serving in the

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military. The participants based their beliefs on what they experienced. Some of the participants reported experiencing some form of MST from the moment they walked into the recruiters’ office until the end of their military career. They described becoming overwhelmed with the men’s constant requests for sex, attempts to force the women to have sex, threats of harm for refusing to have sex, and the touching, grabbing, and patting of their bodies. They all described how this behavior occurred where the participants worked, ate, and slept. Strength thought that the men in the military were being overly masculine and aggressive, “At first, I thought it was just ‘boys being boys,’ but the harassment was non-stop.” The MST was incessant, and it happened everywhere to the point that it seemed normal.

The participants complained about having to learn ways to avoid, reduce, and delicately fend off perpetrators. An example of delicately fending off a perpetrator was when the drill sergeant groped and simultaneously tried to disrobe Imagination all while attempting to rape her, and she tried not to make the drill sergeant angry; “I gently kept removing and blocking his hands. I was trying to keep my military career, while trying to keep him from raping me.” The participants even had to pretend not to hear the sexualized jokes or see the pornographic material in the workplace. They also complained about being emotionally and mentally drained because of the assumption and expectation that their fellow service members and superior officers believed that the women, who were wearing the same uniform and swore the same oath, could be treated like they were the sexual property of the men. The participants felt as if they were treated as if their military service did not matter or was not honored by male service members. In cases when the participants attempted to seek justice by either reporting or threatening to

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report their MST experience, or when they were forced to testify against a perpetrator, none of the women received satisfactory results.

There were either minimal repercussions for the perpetrator or no justice at all. Almost in all cases, the participants suffered some form of retaliation by the military justice system or harassment by loyal peers of the perpetrator. The retaliation and workplace harassment confirmed to the participants that their military service was considered insignificant or did not even matter. It is important to understand the psychological effects and devastation that the participants have internalized about their military service as a result. Regardless of what the participants swore and fully committed their lives to, their military service was insignificant in comparison to their male counterparts. The participants have internalized the rape acceptance culture they experienced in the military and their lack of significance to DoD as dehumanizing.

Theme 4: The dehumanizing effects of MST THOT

MST dehumanizes the survivors (Moor et al., 2013). The lack of respect for the participants’ military commitment and service, and most importantly their bodies, caused the women to feel undervalued. They also felt that they did not have autonomy over their bodies. Both Wisdom and Understanding stopped wearing uniform skirts in the military, because of the overt and degrading sexualized statements made about their legs when they arrived at their permanent duty station. Power’s perpetrator became angry when she told him to stop slapping her buttocks and broke her nose, as if to assert that he could do anything he wanted to her. Even Strength’s superiors communicated that she did not have autonomy over her body when they not only allowed her subordinate to sexually assault

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her publicly, but they also used the military institution to retaliate against her for loudly rebuking the assailant.

Not only did the participants have their autonomy taken away, their freedom and power were also taken from. Determination’s rapist became inflamed with rage when she tried to stop him from raping her. His rage caused her to be in fear for her life. Imagination’s drill sergeant severely retaliated against her when his attempt to rape her was unsuccessful. Wisdom and Power did not have control over their bodies or power to refuse their perpetrators because they had been drugged before they were raped. In Wisdom’s case, the same high-ranking superior who drugged and raped her, had a history of raping other women soldiers. Love and Understanding were raped daily by their perpetrators, whenever and wherever the perpetrators determined. Love and Understanding were violated in their beds and bathrooms, and they were awakened out of their sleep and removed from their place of work, to be victimized and treated as sex slaves by their perpetrators. MST took their freedom and power away.

The participants felt dehumanized to the point that they became numb to the sexual harassment. The dreams and expectations they had about joining the military drastically changed, and their most important goal became to survive in the military. Determination, Understanding, Wisdom, and Love all tried to avoid and hide from their perpetrators (by taking alternate routes to and from work, ensuring that they were never alone in public, leaving the base after work, etc.). Surviving in the military meant avoiding revictimization and exiting the military with an honorable discharge.

Merely surviving in the military went against the original goals of the participants joining the military. Their original goals aligned more with their desire to achieve, learn,

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travel, and become competent and self-reliant, and not just to survive. Power wanted to be a linguist, and Determination and Strength wanted to be registered nurses. Imagination, Love, Understanding, and Wisdom had plans to attend college and choose a profession after the military. Faith wanted to make the military a career. They could have “worked a nine-to-five civilian job to survive and pay for college after graduating from high school,” but they instead joined an intimidating and demanding military organization where they regularly faced seemly insurmountable challenges of the rape acceptance culture and institutional betrayal. Nevertheless, the participants are proud of their decision to join and the contributions they made.

The main reason the participants gave for choosing to join the military was to improve their station in life. Like in the recruitment posters of military members standing tall and erect in pristine uniforms radiating strength and self-confidence, the participants found those images inspiring. They wanted to experience what those images represented. For all of the participants, the media images represented a sense of accomplishment, cohesiveness, and respect that the participants wanted to explore and experience through joining the military. However, the images did not provide any evidence of the rape acceptance culture, retaliatory behavior, and institutional betrayal that were prevalent in the miliary and what the participants eventually endured.

The rape acceptance culture, retaliatory behavior, and institutional betrayal environment is pervasive in the military, and it has made it possible for MST to continue to exist overs 40 years after being identified as a crime that causes dehumanizing effects for the survivors (Fairweather, 2019; González-Prats, 2020; Moor et al., 2013; Speier, 2022). The feelings of hope and expectations that the participants had upon joining the

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military became overshadowed and destroyed by the fear and humiliation caused by MST. The fear and humiliation resulted in shame and guilt being internalized within the participants (Moor et al., 2013). Determination described feeling shameful for not doing enough to discourage the attempted rape by her drill sergeant and his interest in her.

Understanding said returning to her instructor’s class the day after he raped her was as she walked the “walk of shame.” She still some blames herself for causing the rape, “Maybe he felt I was showing off.” She also experienced a severe since of shame when she was her commander’s sex slave and most of her peers and superiors knew and blamed her.

Due to the internalized shame and guilt, they continue to experience a sense of worthlessness to this day. Trying to convince the participants that they are valued and worthwhile is like dropping an ice cube into a pot of boiling water. In this case, the ice cube symbolizes the compliment, and the boiling water represents the participants and how accepting compliments is difficult for them. Wisdom talked about how uncomfortable it is for her to receive compliments, “especially from men.”

The participants actively deflect compliments because they feel unworthy. They expressed how they felt undeserving or unworthy to receive compliments considering how they were treated in the military. Power communicates this point in her interview when she shared about her decision to become an exotic dancer soon after leaving the military, “I might as well be a slut since the military treated me like one.” Becoming an exotic dancer was not what she initially joined the military to do. Power chose to join the military to become multi-lingual and work for the government. Unfortunately for both Power and the government, her unactualized career goal resulted in the military losing

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thousands of dollars spent to train her. The military also lost a service member who was willing and able to perform a job that was required. This shows how MST can have negative consequences for the individual and the government (Speier, 2022). Especially since millions of dollars are spent each year to train, medically treat, and house service members.

The participants’ low self-worth causes them to struggle with their self-esteem and experience self-defeating interpersonal beliefs. The dehumanizing experiences the participants suffered in the military can be explained through the lens of a derogatory term that is used to reinforce the misogynistic beliefs and to blame and shame women by labeling them as sluts and whores. The derogatory term is THOT, which means “that ‘hoe’ over there” or “that ‘hoe’ out there.” THOT is slang mostly heard in modern urban music and frequently said by some men. The term THOT demeans the feminine attributes of women.

The term THOT is utilized to explain the dehumanizing effects of the MST and to demonstrate how this term embodies the misogynistic views men have about women, especially in the military. It has been documented in the second chapter of this study how the military is a misogynistic organization that fosters a rape acceptance culture where the domination and objectification of women are indorsed and sexual harassment and assault are almost expected (Zaleski, 2015). Therefore, the military facilitates an environment that amplifies the psychological and physiological effects of MST and obstructs the justice and healing process for the survivors.

The term THOT embodies what the participants described about how they were made to feel by the pervasiveness of MST, the retaliatory behavior of the perpetrator and

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peers, and the institutional betrayal. The participants indicated that they were treated in such a degrading and dehumanizing manner that they felt labeled and powerless. While they were still serving in the military, they described feeling powerless against what could have potentially happened to their body, military career, and their life after the military. They even questioned the validity of their military service and wondered if it even mattered to the organization that they swore their allegiance to serve and protect. The participants were treated in a manner that suggested that they were THOTs, which was contrary to their preconceived expectations and the images that encouraged them to join the military in the first place. The participants wanted to be respected by their peers and superiors for their achievements in the military. Instead, the participants had to learn to settle for less and compromise in order to survive.

The term THOT is also representative of, and reinforces, the misogynistic and rape acceptance culture and climate that exist and are prevalent in the military. Additionally, the retaliatory and institutional betrayal empowers the military’s misogynistic and rape acceptance culture. As previously stated, the culture and treatment the participants received in the military was degrading and dehumanizing and it caused them psychological and physiological challenges. Trying to maintain their military career became increasingly challenging and wanting to remain was even harder. It became harder for the participants to want to remain in the military because their enthusiasm faded away more and more each time, they were forced to accept the pervasiveness of MST. After each MST incident, Imagination felt unsafe and fearful of losing her military career or being raped. She finally came to the realization that she could never feel safe while serving in “this man’s Army,”

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Theme 5: The thrill is gone broken.

During the course of this study, it became apparent that each participant was initially enthusiastic and motivated about joining the military and the possibilities that their futures held. However, their enthusiasm for the military grew dimmer with each MST incident. They indicated feeling a sense of brokenness or being fragmented by their trauma. Ironically, their commitment and loyalty remained intact even when they were at risk of being harmed in service to the country.

The participants’ enthusiasm and motivation allowed them to trust and blindly commit their life and service to the country and follow the rules and orders of their superiors. But the shock of MST shook the participants out of their enthusiasm and patriotic haze that fueled their desire to be in the military. Unfortunately, the participants were unable to walk away from the military until the end of their contractual agreement, or after being dishonorably discharged. Not being able to freely leave the military after experiencing MST, retaliatory behavior, and institutional betrayal was overwhelming for the participants. Consequently, their enthusiasm and motivation were replaced with fear and resentment. The participants’ fear and resentment were tied to their realization that the miliary did not value them enough to ensure their safety. Their fear and resentment contained their MST experience, a sense of betrayal, concern for personal safety, their military career, and their life after the military. As a direct result of the participants’ fear and resentment, they experienced physical, psychological, behavioral, and relational challenges.

There was a general consensus amongst the participants that female troops are treated as insignificant or like cannon fodder (e.g., trash) in the military, because of the

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incessant MST and rape acceptance culture. Treated like cannon fodder was a widely used term during the 1960-1970s to describe military members who are considered insignificant and expendable and could be hurt or killed to increase the success of the military’s mission (Waller, 2022). Their feelings and thoughts of unimportance and fear, interwoven with feelings of isolation and violation, persistently played in the participants’ minds for the remainder of the time they were in the military. These feelings and thoughts have been internalized within them, and the participants continue to experience them today. The effects (i.e., physical, psychological, behavioral, and relational) of the devastating treatment from the military continue to invade and complicate every aspect of the participants’ lives, including their relationships and careers.

The physical, psychological, behavior and relational effects of MST and the institutional betrayal are revealed in the above summaries of all the participants. They also expressed how they feared the loss of their career and potential retaliation by the perpetrators and peers, which were all traumatic. The trauma the participants suffered in the military eroded their sense of safety and trust. Surviving MST, retaliatory behavior, institutional betrayal, and struggling with feelings of fear, shame, and self-blame surrounding all of it, are linked to symptoms associated with PTSD, depression, and anxiety.

MST is a crime and morally reprehensible, and it should have nothing to do with a person’s military service or to this country. MST should also not define a person’s military experience, but unfortunately it does. The participants endured an overabundance of MST, misogyny, rape acceptance culture and climate, retaliation, or institutional betrayal throughout their career in the military. For the majority of the participants, their

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experiences of MST began while they were in recruit training. For most of the participants, the deciding factor that inspired them to eventually exit the military was related to some form of the continued experience of MST, retaliatory behavior, and institutional betrayal. The prevalence of MST caused the participants to feel and believe that the military is not safe for women, and that their service to the country is considered insignificant. The participants’ internalized feelings and thoughts about their trauma and the treatment by the military, as mentioned previously, are linked to psychological and physiological symptoms. MST caused them to lose their enthusiasm for serving in the military. Accordingly, the retention rate for female troops remaining in the military is extremely low (GAO-20-61, 2020). One of the main contributing factors for the low retention rate of women (28/% separate at a higher than men) remaining in the military is the prevalence of MST and institutional betrayal (GAO-20-61, 2020, 2022). It begs the question of how MST continues to exist in the military after 40 years of officially being classified as a crime. Has DoD maintained dismissive attitudes towards MST survivors and the prevention policies and procedures over the last 40 years?

Theme 6: Willful ignorance on the part of the DoD.

There seems to be some complacency on the part of the DoD, given the superabundance of MST cases over the last 40 years after coming to the public’s attention. According to the participants, the DoD’s complacency implies that it has chosen to be willfully ignorant about the rape acceptance culture and climate that it had allowed to continue to manifest well after MST was recognized as a crime. The GAO report (2022) found that the DoD had not fully implemented 18% of the over 190 unique

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requirements which were imposed in legislation from 2004 to 2021 to address sexual assault in the military (2022). As stated above, the complacency that has been indicated in the GAO report (2022) has been felt and experienced by the women who participated in this study. The participants feel that every branch of the military, therefore the DoD, has been complacent in bringing an end to MST, suggesting that the DoD’s complacency is evident in the fact that misogynistic and rape acceptance culture and climate are flagrant and pervasive in the military.

MST was identified as a crime over 40 years ago, and the DoD has spent over a billion dollars commissioning studies and creating programs to curtail the recurrence of MST. Yet, MST continues to be a problem of epidemic proportions and has ruined the lives and careers of the survivors. Although MST was given a name and classified as a crime over 40 years ago, the participants believe that MST existed long before it gained national attention in 1992. Moreover, the participants feel that the DoD’s willful ignorance is evident in its lack of response to the continuation of MST well after the highly publicized Tailhook Congressional hearing in 1992 and its declaration of “zero tolerance” MST policy (DoD, 2004). It was not until 2004 when the recommendations from the Task Force Report on the Care of Victims of Sexual Assault was published that the DoD began its “ongoing changes in the U.S. military’s response to sexual assault” (DoD, 2004).

The participants believe that the DoD has done very little to change the overall misogynistic mindset of how female service members are perceived in the military, in spite of the fact that the DoD is well aware that MST happens frequently and is a crime based on its own multi-million-dollar commissioned studies over the last 40 years. In

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fact, the DoD has taken steps that are aimed at protecting female service members. One such step is the implementation of the battle buddy program to improve service members’ safety and reduce the occurrence of MST (Lamsberger et al., 2003; Lee, 2018; Wymbs, 2013). However, as was seen in the experience of Wisdom, Imagination and Faith, having a battle buddy did not work as intended and these participants did not feel free to report their experiences. They did not feel safe to report their MST experiences because of the prevailing attitude that reporting these issues would make matters more difficult for them, on the reports would simply be ignored, or under addressed.

In spite of the DoD’s awareness of MST and the measures they have taken to ostensibly prevent it, it seems easier for the DoD to ignore the misogynistic and rape acceptance culture and climate that to continues to exist in the military, than to address those behaviors directly by holding perpetrators more accountable. The DoD has given credence to the other themes of this study (i.e., Government Property–Man’s property and Dehumanizing Effects of MST–THOT) that female service members are treated like they are not valued in the military and that they are the property of men. The participants talked about being caressed, massaged, grabbed, pinched, forcefully propositioned, and spoken to in a sexualized manner in the workplace and even in the war zone, and in front of witnesses. They also described how traveling to and from work and home, or going to the restroom, were obstacle courses the participants had to navigate around to avoid being called “hey baby,” stalked, or raped. The fact that female service members continue to be subjected to this type of treatment suggests that the DoD is turning a blind eye to the problem.

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As previously discussed, two of the participants (Wisdom and Faith) did not feel safe going to the bathroom regularly when they were deployed. The participants did not feel safe because they lived in fear of being raped, which happened to several female service members during their deployments. Love described in her interview how she learned not to go to the bathroom during a certain time of the day. This is because her perpetrator raped her in the bathroom multiple times while she was on medical hold during basic training.

This reluctance to go to the bathroom for fear of being raped has been well documented, and previously known to the DoD. In fact, the DoD commissioned a study to determine the reasons for the high number of urinary tract infections amongst deployed service women resulting in their deaths (Cohn, 2006). According to Cohn (2006), The deployed service women were motivated to avoid keeping hydrated and going to the restroom because they feared being raped. It was clear that women experienced urinary tract infections, and dehydration, at times leading to death, because they refused to drink a sufficient amounts water in order to avoid using the bathroom where they would be vulnerable to being raped (Cohn, 2006). The testimony of Colonel Janis Karpinski, who testified before the Commission of Inquiry for Crimes Against Humanity Committed by the Bush Administration in 2006, indicated several deployed women died of dehydration because they refused to drink liquids late in the day fearing they might be sexually assaulted (2006).

Even though the DoD was well aware of this situation in 2006, another study conducted by Segal and Lane (2016) proposed that there is a frequent occurrence of urinary tract infections for women who are deployed because they avoided drinking water

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and urinating due to the limited amount of private and suitable restroom facilities. Segal and Lane (2016) alluded to the fact that women experience more sexual trauma in the military than in the civilian sector. The participants were not aware of these studies, but they were aware of the phenomenon of the high occurrence of rape particularly that would lead to female service members frequently avoiding drinking water and going to the restroom.

DoD’s complacency was also indicated in what the participants shared about how their peers and superiors turned against them and exhibited retaliatory behaviors in support of the perpetrators. During the retaliations, the participants were blamed, shamed, mistreated, and labeled as sluts and troublemakers. In situations when some of the participants attempted to report their MST experiences, they were the ones who were removed from the workplace and not the perpetrator. The participants’ experiences echo what the DoD studies have found over the years (DoD, 2019, 2020, 2021; GAO, 2014, 2020, 2021, 2022).

Another instance of the participants’ trauma echoing the studies commissioned by the DoD is what Understanding experienced in the military. Understanding, suffered the trifecta of abuses from the military (e.g., MST, retaliation, and institutional betrayal). Understanding is still fighting to upgrade the dishonorable discharge she was unjustly given. She recently wrote to the Department of the Navy, Board of Correction of Naval Records, to petition for an upgrade to her discharge and she was denied. Although the person who responded to Understanding’s request acknowledged the VA’s diagnosis of PTSD related to MST, the person indicated that Understanding’s documented history of misconduct and substance abuse was not caused by the MST experience. The person who

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responded to Understanding’s petition even mentioned the car, in the letter, that the commander co-signed for her, as proof that Understanding was not victimized and treated as slave for two years by the commander but was a willing participant. This case alone demonstrates the DoD’s willful ignorance and the disregard of the complexities of MST, retaliatory actions, and institutional betrayal. Understanding actually testified against the commander about what he had done to her for over two years. Understanding’s testimony even helped to send the commander to prison for what he had done to a newly stationed female Marine, but not what he had done to Understanding.

It is beyond the scope of this project to discuss how or why the perpetrator was sent to prison when such an occurrence is extremely rare. But for the purpose of the current study, the fact that the commander was sent to prison based on Understanding’s testimony indicates that the DoD knew she was victimized 40 years ago. But her testimony was not enough to help upgrade her military discharge in 2022. The response of the person who reviewed and denied Understanding’s request for upgrade did not take into consideration, or may not have known, the psychology and effects of the trauma that Understanding endured throughout her military service (Williams, 2020; Seamone & Tracky, 2012). Understanding is an MST survivor who is continuing to experience punishment, criticism, and judgement for the actions of her perpetrator and the military institution that betrayed her. This case shows that the DoD still disregards the experiences of the survivors, even when they have the facts of a case like Understanding’s.

As was the case with Understanding, several research studies have confirmed how service members were given other-than-honorable discharges in retaliation for either reporting their MST or not complying with propositions for sex (Baltrusches & Karnik,

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2013; Castro et al., 2015; Childress, 2015; Ledesma, 2017; Lofgreen et al., 2017; Marshall/DoD News, 2014; Sterling & Riley, 2016; Zaleski, 2014;). The same research studies also confirmed how service members have received unfavorable discharges due to abusing substances after experiencing trauma (2013; 2015; 2015; 2017; 2017; 2014; 2016; 2014).

The participants feel that the DoD has not exhibited aggressive efforts in reviewing and upgrading MST-related other-than-honorable discharges when it has been determined that the discharges were given in retaliation for MST-related situations. It is not surprising that the DoD would be accused of willful ignorance since it has a long history of being aware of problems in the military but keeping the information private. For example, the DoD has been tracking the high number of suicidal behaviors amongst service members and veterans since 1950, before it was revealed to the general public in 2007 (Filner et al., 2008). The participants believe that the DoD has been aware of MSTrelated cases prior to the 1991 Tailhook case. In Chapter II, it is stated that the service members reported, during the Tailhook hearing, that MST was prevalent in the Navy years prior to 1991 (Lancaster, 1993).

According to the participants in this study, their military experience has taught them that if any organization can bring an end to sexual trauma in its workplace, it would be the military. Beginning in recruit training, new troops are trained in everything from how to brush their teeth to the correct way to wear their uniforms and polish their shoes. The rules, regulations, and military laws are forcibly poured into the new troops during the first few weeks of training. Troops explicitly learn what they can and cannot do very quickly. However, the participants observed and heard misogynistic views about women

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communicated unconsciously and consciously in hyper-sexualized cadences, jokes, and poster images where they worked, ate, and slept. The participants experienced misogynistic views and behaviors from the enlisted personnel and officers, and civilian employees. The participants feel that the blatant misogynistic atmosphere in the military greatly contributed to the rape acceptance culture and MST they endured. They feel DoD can do more to address the rape acceptance culture in the military, which would reduce misogyny and MST in the military.

In addition to the blatant misogyny and rape acceptance culture experienced by the participants, they observed very few women in military leadership roles. The limited female leadership in the military is considered willful ignorance because the participants feel that there should have been more progress in this in this area since 1948, when women were first allowed to join in the military. Of the few women leaders they encountered during their military career, many of them ignored the misogynistic and rape acceptance culture that was prevalent. There were also women service members who engaged in retaliatory behavior towards the participants. The participants experienced betrayal on multiple levels, from peers and superiors, and sometimes from other women, who wore the same uniform as the participants. The treatment caused the participants to feel disillusioned about their military service and insecure about their career, which provoked a sense of anxiety and anger within them.

Willful ignorance on the part of the DoD is also suggested by the fact that the commanders had the sole decisioning-making authority, until December 2021, to determine whether a sexual assault case is investigated and prosecuted (GAO, 2022). The commanders had the authority and power to determine the deposition of these cases even

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though they had no legal training, and they were also within the survivor’s chain of command (GAO, 2022). It is of little consolation that the commanders recently lost the authority to decide on sexual assault cases, because they still had the authority to decide on sexual harassment cases in their chain of command until February 2022 (GAO, 2022). It is bewildering as to why the DoD did not also remove the commanders’ decisionmaking authority over sexual harassment cases in their command when they remove them for sexual assault cases. Especially since survivors often experienced sexual harassment before being assaulted (GAO, 2022).

The DoD’s willful ignorance regarding MST also seems apparent when the military commitment contract implies that it is ironclad, and the service member may become hurt or killed in the service to the country, but the contract fails to indicate the probability of experiencing MST. The contract also fails to hint at the possibility that the service member might endure retaliatory behavior and institutional betrayal related to the MST, or unjustly receive a dishonorable discharge. The point that the participants wanted to make clear, is that they would not have joined the military if they had known about the epidemic of MST or the rape acceptance culture and institutional betrayal.

The participants, feel that they should have been warned about the rape acceptance culture and institutional betrayal that exist in the military. They indicated that the DoD should have included some form of a warning about the prevalence of MST, similar to a Black Box Warning used by the Federal Drug Administration to warn consumers about the side effects of certain drugs (Delong & Preuss, 2021). The participants suggested that a warning about MST should be included in the military commitment contract and the recruitment posters, which would clearly explain that female service members could

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experience a rape acceptance culture and an overtly misogynistic environment during their service to the country. The safety-related warning should also include the probability of experiencing retaliatory behavior if a service member does not comply with the demands for sex or attempts to report the harassment, as well as the potential institutional betrayal for going against the grain of the military by complaining about experiencing MST.

The MST Black Box Warning would also alert unsuspecting potential recruits to the fact that one in three women have experienced some form of MST by a peer or superior during their military service according to the VA (Roza, 2021), and one in four per the DoD (GAO, 2022), experience MST. It is highly unlikely that the DoD would ever issue a Black Box Warning, but it is evident that the DoD is very much aware of the epidemic of MST in the military and the rape acceptance culture. The participants are also aware that the DoD knows.

However, the participants feel that the general public and potential recruits are not aware of the prevalence of MST in the military and should be. The general public, according to the participants, should know about the epidemic of MST because of the tax dollars spent to on military personnel and the treatment of veterans who are receiving clinical and financial benefits to address their MST experience. A Black Box Warning genuinely explaining the prevalence of MST would assist potential recruits in making informed decisions on whether to commit themselves to the military before signing the iron-clad contract. The participants hope that a Black Box Warning, included in the commitment contract, would possibly encourage the DoD to make even bolder changes

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in the military to address the existing rape acceptance culture and completely remove the authority from the commanders regarding MST-related cases.

Summary of the Themes

This chapter first discussed the military commitment contract, basic and boot camp training, and the importance and necessity of following military orders and the consequences of noncompliance. Also discussed were the results of the research study interviews of the eight participants and the detailed synopsis of their trauma. The results were gained by identifying the recurrent themes that emerged from the initial sorting of the data, building a code framework, and establishing emergent themes into primary categories. The themes that emerged are as follows: Where it all begins – the contract and indoctrination (basic and boot camp) training, enthusiastically joined the military for a better life, government property - Man’s property, the dehumanizing effects of MST–THOT, the thrill is gone, and willful ignorance on the part of the DoD.

The six themes and the unpublished poem in this chapter provided insight on and language for a subject that is extremely challenging to talk about, not to mention try to heal from. Because of the difficulty of finding the courage to talk about MST experiences, the therapeutic and healing process was stagnant for the participants. How can people heal from something they are unable to talk about (Doss, 2016b)?

This study unexpectedly provided a relational and therapeutic space for the participants to share about the most life shattering and hope deflating experiences they suffered in the military. The purpose of this study was to understand the lived experience of MST survivors. However, once the participants heard themselves speak about

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something they could not previously talk about, they experienced a sense of enlightenment that opened the door to healing.

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Chapter V

Discussion and Conclusion

Discussion of the Findings

Chapter IV laid out the results of the six themes. This chapter presents the findings and theoretical implications, based on the emergent themes, of the lived experiences of the participants who experienced MST. The themes that emerged were: enthusiastically joined the military for a better life, basic or boot camp training–where the contract and indoctrination begins, government property–Man’s property, the dehumanizing effects of MST–THOT, the thrill is gone, and willful ignorance on the part of the DoD. The findings are related to the internalized military experience of the long-term effects of MST on female survivors and how they are affected by the realization of the interpersonal and institutional betrayal their experience represents (Andersen et al., 2019; Gibson et al., 2016; Reinhardt et al., 2016), on intrapsychic and interpersonal levels. Interpretative phenomenological analysis was the qualitative methodology that was utilized to address the nuances of the experiences of these survivors and to explore in detail how the participants made sense of their internal, personal, occupational, and social worlds. Based on the data derived from the participants and the themes that emerged, the psychodynamic theory chosen to explain how the participants internalized their traumatic experiences, intrapsychically, and interpersonally, is Marvin Hurvich’s (1989) annihilation anxiety theory. Further discussion on the annihilation theory will continue

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after the findings are briefly outlined in this chapter. Then the limitations of the study, and clinical implications for social work and for future research will be discussed.

The Major Findings

The results revealed six major findings. Each finding is explained in its own section of this chapter. The findings are as follows:

1. The participants who were involved in this study joined the military to improve their opportunities in life and to serve the country.

2. For the participants, their military experience began with the iron-clad commitment contract and was memorialized by them being deconstructed and reconstructed, being molded into a collective team, and becoming fully aware of the consequences of a less than honorable discharge.

3. The study participants accepted being the property of the United States Armed Forces, but they became acutely aware that they were also considered the property of the men in the military.

4. For the participants who were involved in this research study, MST is a conscious disregard for their military service as women and as human beings.

5. The emergence and realization of inescapable MST shattered the participants’ enthusiasm for and expectation of achieving a sense of accomplishment, cohesion, and respect that they joined the military to experience.

6. For decades, the DoD has willfully allowed the rape acceptance culture and climate to exist in the military and empowered perpetrators who took advantage of the vulnerability of the women who participated in this study.

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First finding. The participants who were involved in this study joined the military to improve their opportunities in life and to serve the country.

First theme: Enthusiastically joined the military for a better life.

From the analysis of the data, the participants enthusiastically joined the military for better opportunities and to improve their lives. They all knew of a male figure (e.g., father, uncle, brother, etc.,) who once served in the military and their lives seemed to have been improved because of their service. The participants believed that the military would provide them with opportunities and resources (e.g., career and payment for college, medical insurance, and opportunities to travel and see the world) that they would not have otherwise experienced if they had not joined.

Prior to joining, the participants were filled with hope and enthusiasm for the possibility of serving in the most powerful organization in the world, United States military. They understood that the successful completion of their military commitment meant lucrative jobs, payment for college, federal loans, political careers, and other opportunities that would be available to them upon becoming veterans. The participants’ enthusiasm was further based on their awareness that less than one percent of the nation’s general population of women are eligible to serve in the military, and even fewer complete the rigorous indoctrination training (Creative Commons, 2020; Dickerson, 2022). With this in mind, the women who participated in this study are aware that they are a part of a special population of women who were not only eligible to join the male-

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dominated military, but they served and performed well in their various job responsibilities. The participants reported experiencing a sense of excitement and pride because of their military contribution.

Second finding.

For the participants, their military experience began with the iron-clad commitment contract and was memorialized by them being deconstructed and reconstructed, being molded into a collective team, and becoming fully aware of the consequences of a less than honorable discharge.

Second theme: Basic and boot camp training–where the contract and indoctrination begins.

The analysis of the data determined that the military commitment contract is inflexible and irrefutable and consists of dire consequences, and these facts were drilled into the minds of the study participants during the initial training. They are individually deconstructed and reconstructed to function and think collectively as part of a team and to follow orders and rules. The participants also learned early in their training that the military has a well-established history dating back to the American Revolution, and grounded in time honored traditions (e.g., contract, trainings, laws, rules, standards, customs, etc.).

Joining the military for them was both life-defining and life-altering, and their decision to join was one of the biggest and most important decisions they ever made. This commitment was considered a major lifetime and crucial decision for the participants

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because it was symbolically sealed with their blood for a specified period of time. As previously stated, the fact that the contract was iron-clad was drilled into their minds as they were individually deconstructed and reconstructed to function and think collectively (marched, exercised, showered, dressed, studied, etc.) as part of a team and to follow orders and conform to the rules and standards of the military.

As stated in Chapter IV, Fairweather (2019) states that forcing collective activities on the service members establishes a foundation for controlling their thinking and emotions in all situations. The military’s rationale for controlling service members’ thinking is to influence them to accept the new set of values, a collective and cohesive military mindset that sets the groundwork for service members to follow orders. The collective and cohesive military mindset and following orders are some of the military’s time-honored traditions that are necessary to ensure that a given task is performed quickly and efficiently (Dickerson, 2022; Fairweather, 2019). Although these time-honored traditions are necessary, they have been abused to perpetuate a rape acceptance culture in the military. When these traditions are abused, they set the stage for perpetrators to take advantage of the service members’ vulnerability. Given the high cost of forfeiting a military career or not completing the period of commitment to the military, the participants in this study, as well as other female service members, chose their military career and tried to find ways around experiencing MST. Trying to avoid perpetrators was the strategy they used in order to maintain their commitment.

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Third finding.

The study participants accepted being the property of the United States Armed Forces, but they became acutely aware that they were also considered the property of the men in the military.

Third theme: Government property–man’s property.

A close examination of the participants’ interviews and the emerging themes determined that there was an expectation that female service members were not only government property, but also the property of the male service members. The participants in this study described being treated as if they were in the military for the entertainment of men. The participants reported accepting that they were the property of the government for the duration of their military contract. They also reported accepting that they might have been hurt or even killed in service to the military, but the culture and climate of misogyny and rape acceptance took them by total surprise. Therefore, the participants in this study were fully aware of their commitment and contractual responsibility to the military. However, they were shocked and took offense to being treated like the property of men throughout their military service. They felt that the men believed they had a right to the bodies of the women serving in the military. The participants based their beliefs on what they experienced.

According to the participants, a further insult was being treated in a manner that suggested women were insignificant to the military. They believed that they were considered insignificant because they encountered and observed sexual harassment or assault, or retaliation and institutional betrayal from the moment they walked into the

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recruiters’ office until the end of their military career. They reported that male service members made constant requests for sex or attempted to force the participants to have sex. The male service members also communicated threats of harm (e.g., assignment of additional chores and exercises or an undesirable duty location, undesirable discharge, or death) for refusing to have sex or complaining about being touched or having their personal space violated. The rape acceptance culture seemed to have permeated the atmosphere of every military base the participants were assigned to or visited.

The participants reported experiencing some form of MST where they worked, lived, ate, exercised, and shopped by superiors, peers, subordinates, and civilian personnel (former military). Early in each participant’s military career, they reluctantly realized that a culture of misogyny and rape acceptance was inescapably prevalent and normal.

They also described feeling that their military service did not matter in comparison to the service of male subordinates and superiors. The participants based their beliefs on the way they were treated and what was observed throughout their military career. They also based their beliefs on the continuation of MST, low prosecution and conviction rates, retaliatory behavior, and institutional betrayal in the military since MST first became a crime in 1992. In addition, the participants indicated that their belief was validated by the fact that very few women have assumed leadership roles since they officially began serving in 1943 and 1948.1 Therefore, men are still in charge and make all of the decisions, including how MST cases have been handled for the last 30 years since MST was first identified as a crime. The participants believe that the DoD has done very little to change the mindset and culture, and how women are perceived and treated in the military.

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Fourth finding.

For the participants who were involved in this research study, MST is a conscious disregard for their military service as women and as human beings.

Fourth theme: The dehumanizing effects of MST–THOT

From the analysis of the data, it was determined that the participants in this study were dehumanized while serving in the military. Although the participants willingly joined the most powerful and highly respected institution in the world for a sense of safety, security, and purpose, they were treated in a dehumanizing manner and the Armed Forces allowed it to happen. From the perspective of self psychology, safety and security are selfobject needs that are craved and sought to be met in an attempt to rekindle self development. Selfobjects are functions that are experienced by us within our relationships and experiences with other people and that become a part of us (Galatzer-Levy and Cohler, 1990; Lampe, 1999) For the participants, safety and security were the selfobject needs that they thought they would experience in the military. The participants chose the military for the fulfillment of the targeted selfobject needs of safety and security. However, they were dehumanized during their military service The participants believe they were dehumanized by their fellow service members, and then subjected to sexual harassment and assault. The experience of MST denied the participants the most basic human necessity of being seen and treated as humans with the entitlement of autonomy and boundaries (Fairweather, 2019; González-Prats, 2020; Moor et al, 2013).

When the participants’ basic human rights were being violated by perpetrators, and during acts of retaliation, there was no concern for their feelings or wishes (González-

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Prats, 2020; Moor et al., 2013). There was also no consideration of the participants as human beings and military members serving in the United States Armed Forces. The participants were robbed of their humanity and self-worth when they were subjected to any form of MST and objectified. According to Moor et al. (2013), the experience of sexual harassment and assault, being stripped of one’s humanity and treated less than a person, contributes to the diminishment of the survivor’s sense of personhood and causes a deep sense of debilitating humiliation. Moor et al. (2013) postulates that the experience of being treated less than a human being is internalized by the survivor as a tremendous shock that can generate a sense of powerlessness. The dehumanizing and demeaning treatment (objectified as sex objects) the participants endured, while they were under the control and authority of the United States Armed Forces, further memorializes the sense of powerlessness and worthlessness they internalized. Their bodies and military commitment were disregarded, and the military institution failed to protect them. As a direct consequence, their sense of safety and self-worth were severely damaged.

The military is a highly respected institution, overflowing with a surplus of regulations and standards that govern everything from conducting wars to every aspect of the service members’ lives, including how they are to conduct themselves on and off duty. Yet, MST somehow continues to be prevalent after becoming a crime in 1992. The prevalence of MST in and of itself demonstrates the military’s lack of respect and value for the participants’ military commitment and service, and most importantly for their bodies and overall wellbeing. The military did not value the participants in this study, and that their dehumanization was encouraged by the misogynistic and rape acceptance

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culture and climate. The fact that MST continues to exist confirms the military’s the lack of respect and regard for all female service members.

As previously mentioned, the term THOT personifies what the participants described as their experience of the pervasiveness of MST, the retaliatory behavior of the perpetrators and peers, and the institutional betrayal they experience. The participants indicated that they were treated in such a degrading and dehumanizing manner that they felt powerless and lacked autonomy. For the participants, being treated like sex objects dehumanized them and has caused them to question the validity of their military service. Also, the degrading and dehumanizing treatment they receive in the military has resulted in them struggling with low self-worth and self-defeating interpersonal beliefs. They also experience psychological and physiological challenges.

Fifth finding.

The emergence and realization of inescapable MST shattered the participants’ enthusiasm for and expectation of achieving a sense of accomplishment, cohesion, and respect that they joined the military to experience.

Fifth theme: The thrill is gone.

The analysis of the data determined that the participants were initially excited and hopeful about their decision to join the military, but their excitement and hope faded with the realization of the prevalence of the misogynistic and rape acceptance culture and climate. Moreover, with their excitement and hope destroyed, their sense of autonomy and safety were annihilated after experiencing their full spectrum of trauma (e.g., MST,

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misogyny, rape acceptance culture and climate, retaliatory behavior, and institutional betrayal in the military). The participants drastic shift from being enthusiastic and encouraged about being in the military, to feeling hopeless and sexually objectified hindered their ability trust and blindly commit to anything else in the same way they trusted and committed to the military. They lost their enthusiasm and patriotism that once fueled the desire to serve the country, and they were replaced with a sense of brokenness or being fragmented by their full spectrum trauma.

The devastating experience of the spectrum of trauma the participants endured in the military eventually led to them fearing and resenting the institution they swore their allegiance to and promised to serve and protect. Being treated as insignificant, or like cannon fodder, was overwhelming and disrespectful for the participants. The participants exchanged their youth, health, ambitions, and freedom for the trauma they endured in the military and were forced, and still are forced, to live with psychological and physiological challenges.

Sixth Finding.

For decades, the DoD has willfully allowed the rape acceptance culture and climate to exist in the military and empowered perpetrators who took advantage of the vulnerability of the women who participated in this study.

Sixth theme: Willful ignorance on the part of the DoD.

A comprehensive analysis determined that the participants of this study were betrayed by the DoD’s complacency. As previously mentioned, MST first became a

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crime in the military during the early 1990s and continues to be a problem of epidemic proportions; Herdy et al. (2004) cited survivors who reported their MST ordeals to superiors as early as the 1950s and 1960s. This suggests that the military and DoD were acutely aware of the existence of MST within its ranks well before the 1990s. Cases have been recorded as early as the 1950s. The case of Darlene Krashoc shows that the DoD has been aware of sexual trauma cases being perpetrated in its ranks and service members for several decades, and how the DoD has historically mismanaged MST cases. In 1987, Krashoc, a 20-year-old Army Specialist, was raped, tortured, and murdered (Bonvillian, 2021). Although the Army and local authorities jointly investigated the case, her murder went unsolved for 32 years. In 2019, DNA evidence determined that the person who murdered Darlene was her superior in rank and four years her senior (2021). He began serving life in prison for Krashoc’s murder in 2021. At the time of the crime in 1987, the rapist-murderer was never interviewed, even though he was listed as a person of interest. He stayed in the military for 19 years after the rape and murder, successfully retired in 2006 (Bonvillian, 2021).

Another example of the DoD’s willful ignorance is the case of Suezette Bluing, who was stabbed 38 times and suffocated. She was a 19-year-old new Marine who had not been at her base long before she was beaten, raped, and murdered in 1978 (Soto, 2008). The rapist-murderer who was also in the Marines, confessed 30 years later, while in prison for committing a different murder (2008). He provided details on Bluing’s murder under the condition he would not be prosecuted for it (Soto, 2008). The Marine Corps agreed in order to find out the circumstances of her death. Bluing’s rapist-murderer is no longer serving prison time. Upon his release, he applied for and received VA financial

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benefits (Osborne, 2015). He described the details of Bluing’s gruesome murder at his VA Appeals Hearing in a manner that suggests she was at fault for her rape and murder (2015). In an effort to be clear, MST was classified as a crime well before Bluing’s rapist-murderer applied for and was granted full VA benefits. It would seem as though he would not have qualified for VA benefits after admitting to raping and murdering Bluing.

The final example provided in this study of DoD’s history of willful ignorance is the murder of 28-year-old Brandy Fonteneaux, which occurred 30 years after MST became a crime. In 2012, Fonteneaux was murdered in her barracks room, just shy of three years of being in the military (Elliot, 2012; KHOU Staff, 2012; Starr, 2012). She was found in her barracks stabbed 74 times in the nude, and with her nightclothes pulled up around her neck. Her assailant strangled her with her nightclothes after stabbing several times. (2012; 2012; 2012). The sergeant said he was sleepwalking when he ended up in Fonteneaux’s room, because her door was unlocked, during the middle of the night, with his knife (2012; 2012; 2012). When he accidentally bumped into her bed she awoke screaming and fighting (2012; 2012; 2012). The reports describing Fonteneaux’s death never mentioned the term military sexual trauma. The reports did indicate, however, that the sergeant, who was 12 years her senior, had tried to convince her to have a romantic relationship with him, but she refused his advances (2012; 2012; 2012).

Fonteneaux’s murder is relevant to this study because there is a strong indication that the perpetrator’s motivation for slipping into her room in the middle the night while she slept, all while holding a knife, was an attempted sexual assault. There is also the perpetrator’s attempt to convince her to have sex with him, even though she did not know him that well; and her refusal, because “he was married” (2012; 2012; 2012).

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Fonteneaux’s murder is also relevant to the finding of the DoD’s complacent efforts in addressing MST in its ranks. This is evident in the fact that MST was not indicated as a motivation for the perpetrator entering Fonteneaux’s room with a knife while she was asleep and dressed, and that her body was found nude with multiple knife wounds.

It is curious as to why the obvious is not stated in Fonteneaux’s case, which is she fell prey to MST and murder. The perpetrator’s actions indicate that he stealthily crept into Fonteneaux’s room with a knife to rape her, but she fought and interrupted his attempt. Before the murder, the perpetrator also sexually harassed Fonteneaux over a period of time. Although the perpetrator was sentenced to life in prison, he can be paroled within 10 years (Elliot, 2012; KHOU Staff, 2012; Starr, 2012). Since MST was not included as part of his conviction, the perpetrator is not mandated to register as a sex offender if he is released from prison later this year. The message being communicated is that murder is definitely wrong, but pressuring Fonteneaux for sex, then eventually sneaking into her living quarters with a knife while she slept, and ripping her clothing off while fighting her, does not deserve discussion or identification as MST. The DoD’s declaration of a “zero tolerance” MST policy (DoD, 2004) should have kept Fonteneaux safe. If there was an adherence to the “zero tolerance” MST policy at Fonteneaux’s base, she possibly could have been spared such a tragic death.

As previously mentioned, DoD’s lack of aggressive efforts to battle MST continues to be problematic. Willful ignorance of and complacency toward MST describes the DoD’s efforts over the last 30 years, even though MST was happening decades before it was declared a crime in 1992. It is apparent that MST was willfully ignored by the DoD before and long after 1992. Regardless of the plethora of promises made by DoD to

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curtail MST, it continues to exist, along with misogyny, the rape acceptance culture and climate, retaliation, and institutional betrayal. As a result, more women leave the military than join every year (GAO, 2020). If the DoD begins to identify cases as MST related when there is evidence that MST was involved, then maybe work can be done to curtail MST.

How can the DoD address this problem when it is not willing to recognize obvious cases of sexual trauma in the military? It is essential for the DoD to not wait for the next sensational media story to be replayed on multiple news stations about the systemic problem of MST, like in the case of Vanessa Guillen in 2020. It is equally important for the DoD to seriously consider the repercussion of the long-term effects of MST on survivors as they continue to age, especially since the recruitment process promises that the military experience will provide life improving and enhancing possibilities. With this in mind, a Black Box Warning about the high potentiality of experiencing MST should be included in the commitment contract, just like the possibility of being hurt or killed. The Black Box Warning would notify new recruits about the MST epidemic (including misogyny, a rape acceptance culture and climate, retaliation, and institutional betrayal), and how it could possibly be experienced while serving in the United States Military.

The participants feel that the idea of providing full disclosure regarding the seriousness and pervasiveness of MST in the military could encourage the DoD to make even bolder changes in addressing the existing misogynistic rape acceptance culture and climate, retaliation, and institutional betrayal. According to the participants, the DoD’s efforts to be transparent would possibly encourage more women to report their MST experience, remain in the military longer, and even hold more perpetrators accountable

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instead of allowing them to leave or retire from the military with a clean record and honorable discharge.

The participants feel that the DoD sends a clear message to perpetrators, would-be perpetrators, and survivors that it is acceptable to sexually violate lower ranking female service members in the miliary. For example, in 2022, a former Air Force Chief Master Sergeant who was convicted of a sex crime, against a low-ranking service member, was allowed to retire without having to serve prison time or register as a sex offender, received an honorable discharge, and was also allowed to maintain his military retirement pension (Cohen, 2022; Roza, 2022), and he is eligible to apply and receive VA benefits.

To add further insult to injury, 25 of the perpetrator’s superiors (high ranking officers) wrote character reference letters on his behalf before his sentencing hearing (2022; 2022). It is the participants’ belief that an even stronger message communicated is that the military’s weak “zero tolerance” policy protects the perpetrators and disregards and undervalues the survivors. This case is also a perfect example of how the DoD continues to exhibit willful ignorance in addressing MST in its ranks.

Summary of the Findings

The findings that emerged from the interviews with the participants helped to explain their experiences with MST, misogyny, the rape acceptance culture and climate, retaliation, and institutional betrayal. The participants served in all branches of the military, except in the Air Force and the Coast Guard. They all continue to experience the ill effects of their traumatic military experiences. Next, the theoretical implications of this

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study will be discussed. The theoretical implication to be discussed is the analysis of the data through the lens of Hurvich’s (1989) through the lens of annihilation anxiety theory.

Psychodynamic Theoretical Interpretation

The findings demonstrate the attributes of annihilation anxiety theory. The participants endured adult-onset trauma as defined by Hurvich, (1989), while in service to the United Government and as members of the Armed Forces. Throughout the interviews, the participants described feeling hopeless, overwhelmed, struggling to survive, and being in fear of losing their military career or their lives. Thus, the findings can be viewed within the concept of annihilation theory by Hurvich (1989). Hurvich’s (1989, 2003) annihilation theory comes close to making sense of the responses of the data collected from the participants. The annihilation theory definition encompasses feelings of being overwhelmed and falling apart, which is consistent with Kohut’s idea of disintegration anxiety (Hurvich, 1989, Lampe, 1999). Disintegration anxiety is fearing the loss of one’s humanness; “a psychological death,” in which one’s “humanness would permanently come to an end” (Kohut, 1984; Lampe, 1999), which is how the participants internalized their traumatic military events. More will be discussed on this matter below

In efforts to truly understand how the participants were intrapersonally and intersubjectively affected by their military trauma, it is necessary to turn to Heinz Kohut’s (1971) self psychology theory. Kohut (1971, 1977) defined the self as a structure of the mind that evolves over time. The self is the core of the personality that is composed of a collection of experiences that we acquire through our interaction and experiences with others and within various environments. The interactions and

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experiences are internalized as selfobjects and are necessary to maintain cohesion, regulation, and vitality which are necessary throughout our lifetime (Kohut & Wolf, 1978).

When healthy and optimal selfobject functions (e.g., nurturing and positive experiences from caregivers and significant others, achievements of various developmental and academic accomplishments, etc.), are internalized, healthy mechanisms become a part of the self (Kohut, 1971; Lampe, 1989; Wolf, 1994). On the other hand, when the self encounters unfulfilling or adverse selfobject functions, the self suffers from instability and a loss of self-cohesion (Wolf, 1978). Consequently, disruption and fragmentation are experienced.

Selfobjects are needed in the development of psychological structures and the later maintenance of self-cohesion and stability. Selfobjects are psychological representations of others and experiences, that are internalized as part of the self (or as part of ourselves) (Galatzer-Levy and Cohler, 1990; Lampe, 1999). Selfobject functions become part of us by being incorporated within us and built into our internal structure.

Nurturing and positive selfobject functions stabilize and vitalize the experiences of the self and promote healthy psychological development (Galatzer-Levy and Cohler, 1990; Lampe, 1999). Selfobject functions promote development by holding the self through moments of instability and change, which are required for psychological development (Galatzer-Levy and Cohler, 1990). Since psychological development is continuous as one lives and matures, the self continues to require and utilize selfobject functions of others throughout the various phases of adulthood.

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The self, as theorized by Kohut (1971), is organized into three poles, experienced through transferences, grandiose, idealized parent imago, and twinship, and their function is to create and build a strong and vibrant self (Berzoff, 2016). The grandiose pole cultivates confidence, calmness, and self-assurance (Berzoff, 2016; Palumbo, 2008). The idealized parent imago pole seeks an enduring function that leads to the capacity of selfdiscipline and self-idealization. The idealized parent imago also seeks the ideals that a person would strive to become (Berzoff, 2016; Kohut, 1977; Lampe, 1999; Palumbo, 2008; Wolfe, 1988;). The twinship pole focuses on the need for sameness and likeness; someone or an idea to merge with to build upon and confirm a sense of self, which improves one’s self-esteem (Berzoff, 2016; Kohut, 1977; Lampe, 1999; Wolfe, 1988).

In the case of the participants in the study, the military institution represented the selfobjects the participants sought to merge with. The participants joined the military to merge with the selfobjects that encouraged confidence, power, strength, safety, stability, assurance, etc. Unfortunately, the participants were victimized by the very institution they chose to join for the fulfilment of their selfobject needs (e.g., safety, mirroring, strength, stability, validity, reassurance, and a structure to merge with; Kohut, 1971; Siegal, 1996). The military institution betrayed the participants by failing to address and prevent the persistent sexual harassment or protect them from the crime of sexual assault. The military’s failure to prevent, address, and protect the participants resulted in them experiencing shattering and incomprehensible effects in their lives (Dardis et al., 2016; Rasmussen, 2016), affairs, and relationships. The outcome of the participants’ military experience conflicted with the identity, selfobjects, that they idealized and joined the military to develop, and what they expected to experience (Dardis et al., 2016).

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The participants viewed the military with idealization, anticipating an enlivening and validating experience. They idealized the military as the most powerful institution in the nation, which embodied the pinnacle of power and strength and the source of safety and security in the world. Although, the participants chose a non-traditional path to have their selfobject needs (security and a sense of achievement) met, they expected they were going to be safe within the ranks of the United States Armed Forces. The participants anticipated the possibility of being hurt or killed in the line of duty, but they did not envision that they would be violated by their fellow service members and not be protected by the military institution.

The participants sought to have their selfobject needs met through their military experience. With a sense of their need for accomplishment, for confidence within their sense of self, the participants’ hoped-for need was sought in their relationship with the military. Instead of the enlivening response the participants hoped to receive from their military experience, they felt the traumatic disappointment and dehumanizing experience that inhibited and damaged their self state. Now, since the intrapersonal and intersubjective effects of the participants’ military trauma have been explained, the discussion will turn to Hurvich’s (1989) annihilation anxiety theory.

According to Hurvich (1989), annihilation anxiety is caused by the threat of danger to one’s psychic survival, experienced as an anticipation of an imminent catastrophe. The experience entails feelings of helplessness in the face of internal and external dangers without hope of any form of protection (Hurvich, 1989, 2003). Annihilation anxiety is a consequence of psychic trauma, object loss, and pathology of the self (1989, 2003). This traumatic situation threatens self-cohesion (1989, 2003).

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Hurvich’s (1989) theory builds on Freud’s (1920, 1936) traumatic situation which involves a person encountering an imminent danger and experiencing feelings of overwhelming dread and helplessness (Hurvich, 1989, 2003) As a matter of fact, there is a common thread between Freud’s traumatic situation, Klein’s psychotic anxiety, Bion’s nameless dread, Winnicott’s unthinkable anxiety, and Kohut’s disintegration product (Hurvich, 2003). These theories provide a deeper understanding of the effects of massive psychic trauma.

In developing his theory, Hurvich (1989) is very specific from where his annihilation anxiety theory is inspired from. However, the majority of the above theorists focused on childhood-onset trauma Like Kohut, Hurvich’s (1989) theory focuses on beyond childhood, adult-onset trauma. Hurvich (1989) focuses on adult-onset trauma, and for this reason, the annihilation anxiety theory is the most appropriate theory to explain how the participants in this study were affected by their adult-onset trauma

Before continuing the discussion on how annihilation anxiety theory is the most appropriate theory to explain how the participants internalized their traumatic military experiences, two essential facts must be discussed. First, it is important to explain how the power differential in the military, when abused, is comparable to what is experienced when incest or molestation exist in the family or church. Secondly, it is also essential to address how the effects of MST, in conjunction with retaliation and institutional betrayal, are comparable to the traumatic effects that are experienced as a result of war

The military’s projection of power and the glorification of dominance, both psychological and physical, in addition to its betrayal of trust, were negatively experienced by the participants on interpersonal and intrapsychic levels. Consequently,

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the participants were affected psychologically and physiologically, and the effects have impeded their ability to heal. As previously stated, perpetrators who are associated with the military are often authority figures or have some form of power (e.g., supervisory position, in the chain of command, physically strong, carrying a weapon, or having a history of killing in combat) over the survivor, which is comparable to what is experienced between molesters and children (Brothers, 1992; Dardis et al., 2016; Dickerson, 2022; Frankel, 1998; Ferencz, 1932, 1949; Smith & Freyd, 2014). The power and authority dynamic in the military, when abused, has similar effects on MST survivors just as it has on child incest survivors (Brothers, 1992).

Child incest survivors depend on their relationship with the same family member who betrays their trust for their basic needs and survival (Brothers, 1992). The participants also depended on their trusted superiors and peers to effectively perform in their jobs and for their survival. The participants were in a committed relationship, a relationship of care and trust, with the military institution, and they were betrayed and violated by those who were in a position of authority and power (Smith & Freyd, 2013).

As previously mentioned, MST is an interpersonal trauma, which involves a betrayal by a trusted individual that can cause lasting physical and psychological harm to the survivor (DePrince & Gleaves, 2007; Dickerson, 2022; Fred, 1994, 1996; Lofgreen, 2017; Smith & Freyd, 2013). The betrayal of trust caused the participants to experience a sense of vulnerability and the inability to feel safe (Brothers, 1992). They also felt fragmented (1992). The betrayal of trust also disrupted their relationships with themselves and others (1992). Not being able to trust others or themselves has resulted in

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the participants experiencing a trust disturbance, which causes an intensification and diminution of self-trust (1992).

The intensification and diminution of self-trust are responsible for the dissociative nature of PTSD symptoms, which are related to the participants’ experiencing a sense of depersonalization and derealization (Brothers, 1992). The participants repeatedly mentioned experiencing a sense of depersonalization and derealization as they were going through their traumatic events. They also described experiencing feelings of intolerable “humiliation, narcissistic rage, and terrifying experiences of fragmentation and depletion” because of the MST and institutional betrayal they endured by trusted representatives of the United States Armed Forces (1992). This was contrary to the supportive and nurturing opportunities they joined the military to experience.

The supportive and nurturing experience the participants (Blum, 2013; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000) joined the military for, turned into an experience of frustration and paralyzing fear (Blum, 2013; Dickerson, 2022; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000;). The participants’ traumatic military experience was caused by the MST and rape acceptance culture and climate perpetrated by fellow service members who abused their authority, which was also experienced as a massive psychic trauma for the participants (Peláez, 2009; Rachman, 2000; Ferenczi, 1932). Further, the betrayal they experienced by the respected and trusted Armed Forces institution was also devasting and overwhelming for the participants.

A massive psychic traumatic event, such as MST, has lasting negative psychological and physiological effects that are similar to what survivors of war trauma have endured

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(Ferenczi, 1932; Peláez, 2009; Rachman, 2000). MST is considered a massive event because the participants’ careers, safety, and lives were threatened, and they were also betrayed by an institution that they swore their loyalty and allegiance to. For the participants, the facilitation of any form of MST, misogyny, and institutional betrayal were experienced not only as a massive trauma, but as symbols of annihilation because their survival was in jeopardy. Like survivors of war, the participants experienced devastating issues, such as dysfunctions within the survivor’s personal and social relationships, and lasting dynamic traumatic responses (Boulanger, 2007; Bourke, 2012; Clements et al., 2004; Dickerson, 2022), including ongoing fear, emotional instability, and high-risk behavior. In addition, they all are diagnosed with PTSD (e.g., recurrent thoughts, intrusive visual and auditory hallucinations; Boulanger, 2007; Clements et al., 2004).

Each of the participants experienced some form of MST during their military service. They all had the experience of having their control and power taken away as a result of the MST they endured by a superior or someone with power or some form of control. Power differences (superiors and subordinates) are prominent in the military and are expected. This power differential, which is also a tradition in the military, can have a traumatic effect when a person experiences MST committed by someone who has power over them (Dardis et al., 2016; Ferenczi, 1932; Smith & Freyd, 2014). Ferenczi (1932) affirms that a person’s power over another (i.e., unequal balance of power, control, and status) is traumatic for anyone who has less power when the power is abused by one who has more power or control. This is because the person with less power, (the subordinate) then becomes vulnerable and lacks control (Dickerson, 2022; Frankel, 1997, 1998).

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Chapter II of this study discusses the two types of influences that a person in a position of power has over another as described by Ferenczi (1932, 1949). One influence is through love and tenderness, a maternal form of influence that is supportive and nurturing in nature (Blum, 2013; Dickerson, 2022; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000). The other form of influence is through authority or power, which is considered paternal and involves threats and promises of rewards (Blum, 2013; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000). The paternal influence is more corrective and authoritative and can be abused by the person who is in control or the person who has power (Blum, 2013; Dickerson, 2022; Ferenczi, 1932; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000).

The military does utilize paternal influence to quickly train and to maintain order and compliance, which is understandably necessary. However, the participants experienced an abusive form of paternal influence by trusted people who abused their authority, control, or power when they perpetrated MST or engaged in retaliatory behavior (Fairweather, 2019). The abuse of authority, control, or power to influence service members to conform and submit also affected them interpersonally and intrapsychically, which caused feelings of vulnerability and a loss of agency in the survivor (Blum, 2013; Frankel, 1998, 2017; Peláez, 2009; Rachman, 2000). The interpersonal and intrapsychic effects of MST are even more pronounced for the participants because they were in a committed relationship of care and trust with their perpetrators and military institution.

Moreover, the participants were betrayed and violated by those whom they idealized and were in positions of authority and power (Dickerson, 2022; Smith & Freyd, 2013).

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The betrayal was committed by an institution that they thought was all powerful and had absolute authority over every aspect of their lives, similar to what is experienced in a parent-child relationship. Essentially the abuse by the military resulted in a loss of trust in the idealized entity, which affected them intrapersonally and intrasubjectively. This means the abuse adversely affected the participants’ ability to relate to and trust others, including themselves. As a result, the participants’ ability to feel safe and experience selfassurance, positive self-esteem, self-cohesion, etc., were also grossly affected.

In conjunction with the betrayal and violation the participants endured by the military, they had to continue to maintain a working relationship with, or see, the perpetrator in order to effectively perform in their jobs, or for their survival in times of war. Although the participants were forced to either work with, around, or continue seeing their perpetrators, it did not mean they were not affected by their MST experience. As a direct result of the abusive paternal influences experienced by the participants while in the military, the participants reported experiencing feelings of helplessness, being under attack or overpowered, overwhelmed, terrified, and angered by a person who was in authority or had power over them (e.g., through superior rank or position, as a member of the majority race, by being armed, or through the ability to hurt or kill). Further, the betrayal also resulted in the loss of self in the idealized entity.

Based on the above comparisons of the aftereffects of molestation or war to the residual effects of MST, Hurvich’s (1989, 2003) annihilation anxiety theory is the most fitting psychodynamic theory to explain how the participants internalized their adultonset and military trauma. The annihilation anxiety captures the depth of the overwhelming and disorganizing terror the participants endured while serving in the

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military. Hurvich (1989, 2003) contends that the fear of being overwhelmed or annihilated correlates with Freud’s trauma theory. According to Freud (1920, 1936), the fear of loss of love, castration, superego condemnation, and fears of disintegration of the ego and of the self are experienced as a sense of danger and trauma. Intense feelings of being overwhelmed, losing control, or being anxious are expressions of annihilation anxiety. According to Hurvich’s (1989, 2003) annihilation anxiety theory, these expressions are closely related to fears of the fragmentation of the self and feeling broken. Experiencing fears of the fragmentation of the self or feeling broken are what was revealed by the participants throughout their interviews.

Hurvich (2003) also describes annihilation anxiety as a threat to one’s survival with its origin in early development but may be provoked throughout life whenever experiencing a perceived threat to survival (Lampe, 1999). Annihilation anxiety, resulting from a trauma event or moment, contributes to severe psychopathology (e.g., panic, nightmares, phobias, borderline, narcissistic and psychotic conditions, dissociative states, perversions, psychosomatic disorders, and PTSD; Hurvich, 2003). A traumatic event or moment for the participants constituted a dangerous situation and situations anticipated to occur in the future or concerns about being overwhelmed (Hurvich, 2003, 1989). The participants experienced direct violations by trusted members of the military, and they anticipated other harmful events that could have ruined their military careers and lives after the military.

As previously mentioned, the MST and institutional resulted in the participants experiencing narcissistic rage. The narcissistic rage is a reaction to an injury to the core of the self (Berzoff, 2016) that was caused by their traumatic military experience that also

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made them feel powerless and ashamed (Kohut, 1977). The participants experienced paralyzing fear and as if they were losing themselves. This level of annihilation anxiety is considered psychotic because it gives way to intolerable anxiety and rage (Berzoff, 2016). Annihilation anxiety is experienced on a psychotic level as a fear of disintegration of the self or identity (Berzoff, 2003, 2016).

As mentioned earlier, disintegration anxiety is fearing the loss of one’s humanness; “a psychological death,” in which one’s “humanness would permanently come to an end” (Kohut, 1984; Lampe, 1999), which is how the participants internalized their traumatic military events. The participants felt, and still feel, that they were robbed of their humanity and self-worth because of the demeaning way they were treated by the military (e.g., misogyny, rape acceptance culture and climate, retaliatory behavior, and institutional betrayal). For the participants, the associated humiliation and shame they have internalized because of the inhumane treatment while serving in the military (e.g., treated as if they were sex objects and worthless), have caused them to question their military contribution and self-worth.

The internalized humiliation and shame have also caused the participants to bury their military trauma deep within, which has kept them from verbalizing the most horrifying moments of their trauma until they were interviewed for this study. Previously stated, the participants experienced difficulty in finding the strength and courage to talk about their MST experience, and the accompanying retaliation and institutional betrayal they endured. As a result, their therapeutic and healing process was stagnant because they were unable to talk about their overwhelming traumatic history in the military. Interestingly, the study gave the participants an opportunity to talk about their military

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experience. The participants being able to finally talk out loud about their military trauma history unexpectedly allowed them to experience a relational and therapeutic space that made it safe for them to share their most life shattering and hope deflating experiences they suffered in the military (Dickerson, 2022).

In essence, understanding why the participants chose to avoid talking about the details of their trauma, and the resulting intense psychological challenges, can best be explained through the lens of Hurvich’s annihilation anxiety theory. Hurvichs’ annihilation anxiety theory (1989, 2003) encompasses feelings of being overwhelmed and falling apart. The annihilation theory provides a deeper level of understanding of the intensity of the avoidance and psychological challenges caused by the participants’ military trauma history. The annihilation anxiety theory also helps us understand why MST survivors avoid talking about their trauma history, which impedes their ability to process and heal from their experience. The participants avoided talking about their trauma because they experienced the threat of danger to their psychic survival and experienced an anticipation of an imminent catastrophe (e.g., their military status and job, career after the military, and personal safety; 1989, 2003). The memory of their traumatic military experience entails feelings of helplessness in the face of internal and external dangers without hope or protection (Hurvich, 1989, 2003).

The memory of the participants’ traumatic military experience made them feel helpless, and therefore prevented them from talking about their past. During the interview process for this study, the participants learned that avoidance is one of the reasons why they tried to distance themselves from their military trauma history and continued to experience the continued residual effects. As indicated earlier (i.e., “How can people heal

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from something they are unable to talk about;” Doss, 2016a), verbalizing a horrific and life altering trauma one has experienced is an essential part of the healing process. This is especially true when one’s military trauma can adversely impact one’s life and affairs several years after serving (e.g., relationship problems, employment challenges, medical and mental health problems, substance abuse, suicidal ideations, and suicide-related deaths). Understanding the participants’ adult-onset trauma through the lens of Hurvich’s (1989) annihilation anxiety theory will assist clinicians in providing a relational and therapeutic space for MST survivors to process their most life shattering and hope deflating experiences they suffered in the military.

Limitations of the Study

A limitation of this study was that it neglected to discuss and highlight the research on the link between MST and the high rate of suicide amongst female service members and veterans, which is a real concern (DoD, 2022b; Padilla, 2022; Thomas and Hunter, 2019). Also, the sample used in this study was small and does not accurately represent the larger, general, population of MST survivors. This would include male MST survivors because their lived experience is just as significant and horrific.

Future Research

When considering the findings and implications of this study, future research should explore the lived experiences of male service members who are survivors of MST. This is especially necessary since MST has historically victimized more men than women. Traditionally, more men have served in the military than women, and 80% of the military

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population is male. Another consideration for future research is to determine the frequency and rationale of MST survivors who abruptly partner or marry in efforts to avoid or reduce the frequency of MST, as well as the outcome of the relationships (e.g., domestic violence, divorce, etc.). Additionally, the intergenerational transferences that affect familial relatedness should also be explored. Like combat, the residual effects of MST affect the veterans’ relationships with significant others (partners, spouses, children, etc.). It would also be interesting to explore the occurrence and frequency of MST experienced by minority service members, and research the high occurrence of suicide amongst MST survivors. Another interesting study would involve exploring the psychological effects of MST on National Guard and Reserve members and veterans who are excluded from receiving VA medical services if they have never served on active duty, or for less than 20 years, until they apply and receive VA compensation benefits (VHA MST Directive 1115, 2018). A final point of interest would be researching VA treatment outcomes for the MST survivors who are treated at unisex therapeutic inpatient programs rather than an all-male or all-female program to address their MST experience.

Clinical Implications (for Social Work Practice)

This study is significant for clinical social work because social workers, either civilian or military, may encounter female patients who may potentially have a prior military history and may have experienced MST, or other adult-onset traumas that are unknown to the therapist. Research studies find that, upon leaving the military, only half of the women receive medical treatment at VA medical facilities (Cichowski et al., 2019). This finding suggests that at least half of the women who suffered MST while serving

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will not receive treatment to address their symptoms, which are directly related to their traumatic experience (2019). Consequently, if there is a confirmed history of MST, and it has been adversely internalized by the patient, this trauma remains hidden and unprocessed within the therapeutic setting. Typically, the therapeutic setting focuses on issues pertaining to the patient’s childhood or a current event without addressing the adult-onset trauma (Boulanger, 2007). The therapist’s neglect to assess for the military experience, and symptoms related to possible MST, may significantly impact the therapeutic process and hinder the patient’s personal growth (Cichowski at el., 2019). This is especially true when the therapist is not mindful of the unconscious transference and the fluid exchange of action-reaction (countertransference) between the survivors and clinicians (Jennings-Miller, 2016).

The analysis of the data compiled from the lived experience of female survivors of MST revealed an in-depth understanding of how they have internalized their trauma and how psychodynamic interventions may assist them in improving the quality of their lives, relationships, and personal and occupational affairs. By implication, the results also aided in expanding the awareness within the psychodynamic community of the importance of asking a patient if she had ever been in the military service, assessing if an MST history exists and exploring with the patient how it had been internalized. The assessment of a military background and for a possible MST history with the accompanying symptoms, may encourage the development of more appropriate treatment strategies. Moreover, the results may further aid the therapist in considering psychodynamic treatment strategies to assist in strengthening the survivor’s ability to connect and emotionally relate to the self and others (Burkhart & Hogan, 2015).

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Another significant consideration is the necessity of social workers, psychotherapists, and clinicians from all mental health disciplines to improve in their efforts to engage in socially responsible clinical practices in informing and educating all service members and veterans about the prevalence of MST in the military. They should also be informed about the available services and treatment for MST experience (Litz, 2014). For example, an assessment can begin by asking if there is a prior military history, and then subsequently asking if the patient has experienced any form of MST while serving. The catastrophic and long-term effects of MST are too devastating to ignore, especially since the rate of women joining the military and, subsequently, becoming veterans is significantly increasing (Dever, 2019, Dickerson, 2022; Patten & Parker, 2011; Reynolds & Shendruk, 2018). These survivors will need help in understanding and dealing with their incomprehensible and devasting military experiences as they continue to live and age.

Conclusion

During the course of the study, I explored the context of the lived experience of female MST survivors. Data were gathered through open-ended questions that attempted to capture an understanding of the participants’ experience and perception of their MST, retaliatory experience, rape acceptance culture and climate, and institutional betrayal through the lens of psychodynamic theory. This study found that the lived experience of MST survivors has many complex layers that have been internalized, and each layer plays a role in how the participants processed their military trauma.

The complex layers consist of the initial enthusiasm and expectation of achieving a

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sense of accomplishment upon joining the military. Next is the experience of the ironclad commitment contract, accompanied by being traumatically deconstructed and reconstructed into a collective and cohesive team and becoming fully aware of the consequences of a less than honorable discharge. Afterwards, there is the acceptance of being the property of the government while serving in the military and the reluctant acceptance of also becoming the property of men. Then there is the realization of being dehumanized by the misogynistic and rape acceptance culture and climate in the military. Also, how the inescapable MST experience shattered the participants’ enthusiasm about being in the military and their hope for a better future. Finally, realizing and accepting that the DoD is complacent about the prevalence and lasting effects of MST. The participants revealed and shared their most intrusive and soul-crushing experiences during their interviews. Their contributions to uncovering the lived experience of MST are vital in understanding how the trauma is internalized for survivors. The participants’ contribution to the study revealed the importance of understanding the lived experience of MST survivors, and the multi-dimensional layers that are interpersonally and intrapsychically internalized by them. As mentioned previously, the catastrophic and long-term effects of MST are too devastating to ignore for the survivors, the military, and for society as a whole. Although MST is often called an invisible war, it is not invisible. The participants’ contributions helped reveal that MST is an often disregarded and underrecognized war within the ranks of the military that causes both visible and invisible wounds for the survivors.

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Appendix A Flyers

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Appendix B

Initial Phone Contract Script

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When potential participants contact the researcher expressing interest in the study, the following initial phone interview will be used to determine their eligibility:

Hello, my name is Renee Dickerson - I am a Ph.D. candidate at the Institute for Clinical Social Work in Chicago. I am conducting a research study about the lived experience of female veteran survivors of sexual trauma in the military (MST) as well as the effects on them as they continue to age. To determine your eligibility for the study, I will ask a few questions:

● Are you 18 years or older?

● Have you been discharged from the military?

● Are you currently in treatment for military sexual trauma?

● Are you enrolled at the VA for medical or clinical services?

● While serving in the military were you touched in a way that made you feel uncomfortable, forced to see or do anything you did not want to see or do, or had anything done you did not want to have done to you? I am asking if you were sexually harassed or assaulted (MST) during your military career?

● Would you be willing to participate in three interviews: two face-to-face interviews and a follow-up phone interview? (If yes, I will ask for more contact information so that a listing of websites with helpful information can be emailed to the applicant).

● If you meet these criteria, do you also agree to be video and audio recorded? I would also need to see your military discharge paper and driver’s license to confirm your eligibility and identity, but I will not be collecting any identifying information. Your participation is entirely voluntary. If you meet the criteria for

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inclusion in the study, you may be asked to be interviewed three times and agree to be interviewed. You may skip any of the questions that you don’t want to answer, and you may stop the interview(s) at any point. Your historical account will be collected through semi-structured and open-ended questions. During these interviews, you will be encouraged to discuss your military experience, including your ideas, challenges, thoughts, and feelings about the military and your life afterwards. The interviews would be audio and video taped upon your consent.

Additionally, toward the end of this research, I would like to verify your responses using a transcription of the interviews. This is to be sure I have documented your thoughts and reflections accurately. Again, participation in the study involves three interviews:

● Two face-to-face Zoom meetings (if more convenient, the second interview can be done over the phone).

○ The second interview would be approximately two weeks after the first.

● One “well-being” interview via phone to check-in, answer any questions and, provide referrals for additional services.

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Appendix C

Welcome Email

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Dear Participant,

Thank you for agreeing to participate in this research. As we discussed on the phone, I am conducting a research study about the lived experiences of sexual trauma in the military (MST) survivors as they continue to live, work, and function with the lasting effects of MST. During our time together, I will ask you some questions about your experiences, thoughts, and feelings about your life during and after the military after you experienced MST, which will include any challenges, triumphs, worries, and hopes, and coping mechanisms.

As I mentioned over the phone, your participation is entirely voluntary, and you may skip any questions that you do not want to answer. You can end the interview at any time if you become uncomfortable or triggered. No personal identifying information is being collected, and you can choose a false name that will be used during the write-up. Any personally identifiable information collected during the survey will be kept strictly confidential. The recordings and transcriptions of those recordings will be anonymized and kept in a secure location where only the researcher will have access. If, at any point in time, you are feeling distressed and wish to stop the interview, just let me know, and we will stop until you are ready to resume.

Before we go any further, please allow me to provide you with a listing of the local Veterans Affairs (VA) facilities and community-based mental health programs located in your community. I also want to give you the VA’s informational fact sheets or websites, which provide the legal definition of MST and list services and programs (mental health and possible medical services and assistance in applying for disability compensation related to the military sexual trauma) offered by the VA. Further, I would like to

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emphasize the importance of you considering enrolling for treatment for MST at either a VA or community-based mental health facility. I recommend that you consider seeking therapy as you participate in this research because talking about your history of MST and later events may become intense and traumatizing for you. You may benefit from the support that therapy can provide you. Do you have any questions about the research study? Please review and initial below to consent. Thank you for your service!

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Appendix D

Information Packet

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Find VA location near you - https://www.va.gov

Finding a therapist in your community: https://www.psychologytoday.com/us/therapists

MST definition - https://www.va.gov/health-care/health-needs-conditions/militarysexual-trauma/

VA benefits MSThttps://www.benefits.va.gov/BENEFITS/factsheets/serviceconnected/MST.pdf

VA Mental Health - https://www.mentalhealth.va.gov/mentalhealth/msthome/index.asp

VA Health Care - https://www.va.gov/health-care/health-needs-conditions/militarysexual-trauma/

VVA’s Guide on PTSD - https://vva.org/wp-content/uploads/2014/11/PTSD.pdf

VA disability questionnaireshttps://www.benefits.va.gov/compensation/dbq_publicdbqs.asp

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Appendix E

Interview Questions

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• What was your reason for joining the military?

• How old were you when you joined?

• What did you imagine your experience would be in the military?

• Explain where you were when the MST occurred (at a regular duty station or on deployment during a conflict or war)?

• Can you describe your experience with MST, including the timeline?

• How old were you when the incident happened?

• Did you become pregnant and if so, what happened to the baby?

• Did you end up in a relationship with the perpetrator and how long did it last?

• At any point, did you feel that you were in a relationship with the person who violated you? If so, please explain.

• Were you able to turn to anyone for help?

• How did you feel after the incident?

• How has your MST experience impacted your life, that of your family?

• Have you ever experienced thoughts of not wanting to wake up the next morning, not wanting to exist…? If so, please explain.

• What about wanting to harm others? If yes, please explain.

• Survivors often blame themselves for the MST they endured. What are your feelings about this?

• If you experienced any form of sexism or racism in the military, please explain.

• Overall, what does your military experience mean to you?

• Potential Additional Prompts:

• Were you enlisted or a commissioned officer?

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• What was the rank of the perpetrator, and did he or she outrank you?

If you were discharged from the military for reporting MST, what was your experience?

• If you reported your MST incident, what was your experience?

• If you did not report your MST incident, what was your experience?

• How long did you remain in the military after the MST experience?

• How has the MST experience affected your medical and sexual health?

• How has the experience affected you mentally?

• How has the experience affected you emotionally?

• How did you become involved in treatment for MST at the VA?

• What was your experience in initially seeking treatment for MST at the VA?

• What has been your experience in receiving treatment for MST?

• How long have you been involved in treatment for MST?

• How do you feel about the military today

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