Take it from me, a psychiatrist: Duke has a serious sexual assault problem

Welcome to Duke, both new and returning students.  Before you arrived, you watched a video training about sexual assault; you will get talks about alcohol and drugs, too.  You may have taken it seriously, or you may have texted with friends, scrolled through your Insta account or watched some Netflix at the same time. You may have experienced some of the things they described before coming to Duke. Or, you may not think it will happen to you. 

I am a psychiatrist in Durham, and have worked in proximity to Duke for over 30 years.  During that time, I have treated numerous Duke students who were sexually assaulted, many by other Duke students. The harmful impact of those assaults is often both life altering and life long.  Some had to leave Duke, unable to continue because of depression or panic attacks after the incident, others were hospitalized for suicidal thoughts. Some never told anyone, at the risk of losing their entire friend group, because their attacker was an integral part of it.  As unique as each person is, so are the stories of their assaults and resultant suffering.  

A survey published in the Chronicle last year showed that 48.5 percent of female students and 13.5 percent of male students reported a sexual assault during their time at Duke.  These are staggering numbers, and data shows that sexual assault is typically underreported.   

All of you are smart, or you wouldn’t be here. Here is some science to ponder. Duke professor Dan Ariely did a profoundly intriguing, disturbing study about the effect of sexual arousal on judgment and sexual decision making in college age men. The results are stunning.  For example, sexual arousal increased willingness to engage in morally questionable sexual behavior such as drugging women to have sex and continuing to try to have sex even after a date says, “no.”  

Alcohol and sexual arousal also impacts the decision making capacity of women. When they want to make friends, are in a new place, are feeling insecure. There is the choice to leave a party with someone, thinking that you’ll just kind of fool around but not have sex, that when you’ll say no, they will listen.

The other critical neurologic inflection point is when the midbrain enters  “freeze” mode rather than fight or flight mode you learned about in biology.  Like possums playing dead when threatened, like the gazelle caught by the lion, our brains can also release a flood of neurotransmitters in a dangerous situation, so that we don’t feel ourselves being harmed, raped or eaten alive, as in the case of said gazelle. It’s an adaptive mechanism, at times.  I have worked with so many students who described being unable to escape, either because their assaulter was stronger, because they felt ashamed or felt that they had invited this, or most frequently, because they had entered this dissociative state. “I couldn’t cry out,” “I just lay there waiting for it to be over,” “I had said no and he didn’t listen and I couldn’t move,” are themes I hear repeatedly.

They then hold the trauma in their bodies, experiencing a lifetime of anxiety, depression, hypervigilance or other symptoms of PTSD.  These students spend time and money on treatment, if they are fortunate to have access and resources and make the choice to do so.  The perpetrators are often unaware that they have caused this, as confrontation or disclosure is risky for many reasons.

If I can prevent even one assault by writing this, it will be worth it. Look out for your friends.  Don’t trust anyone you don’t know. We make the assumption that if they are a Duke student, they are trustworthy.