Perceptions of People With Mental Illness as Sexually Exploitable

The prior conviction for statutory rape was a warning. Nonetheless, he passed a background check and the psychiatric hospital hired him to work with severely ill patients. Before long, he was having sex with multiple women confined to the hospital. In his mind, the women were willing partners, but a sex crimes conviction contradicted this interpretation of events.   

Terrible as it is, sexual abuse of psychiatric patients is far from shocking. What makes this particular victimization so unsurprising? Based on my research, one factor seems to be the common perception that people with mental illness are easily exploitable.

The Nature Of Spotting Victims  

Animals have evolved to exploit victims. Cutthroat as it seems, examples of exploitation should be familiar from a lifetime of nature programs. The lion culls a slow gazelle from the herd. The silverback gorilla pummels a weaker male to maintain troop dominance. The cuckoo lays its eggs in the nest of another bird that fails to jealously guard its territory. 

Humans also exploit. If there is a desirable resource, people have invented a way to take it from others. This includes sex. People use false charm to seduce potential mates. They deceive with lies about personal attributes and intentions. Most troublingly, people pressure others into sex with unrelenting demands, and they coerce with threatened or actual force.  

Exploitation is not random. Lions do not attack the fastest gazelles in the herd. Rather, they spot the slow, weak, or sick prey that can be easily caught. If humans use others for sex, then they too must use cues to spot the easily exploited. Evolutionary theorists have proposed numerous cues that could signal vulnerability to sexual exploitation. They include psychological traits such as low self-esteem, naivete, low intelligence, recklessness, impulsivity, attention-seeking, drug use, and intoxication.

To be frank, the vulnerability cues read to me like a list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders. Across several research studies, I have shown that this similarity is no coincidence.

Mental Illness And Sexual Exploitability

Despite the common myth that people with mental illness are dangerous, they are the ones at increased risk for crime and victimization. Rates of sexual assault are especially high. Why assault them? My research suggests that people view individuals with mental illness as sexually exploitable.   

The task of connecting mental illness with sexual exploitability occurred in several steps. The first step was to determine if people associated cues of exploitability with mental illness. To do this, I asked people to indicate if a long list of previously established cues of exploitability—anxious, reckless, intoxicated, immature, acts unintelligent, etc.—were more typical of individuals with or without mental illness. On average, people associated sexual exploitability cues with mental illness.

The next step was to determine who people think can be exploited. I asked people to compare how easy it would be to pressure, deceive, and coerce a person with or without mental illness into having sex. People indicated that they saw individuals with mental illness as more vulnerable to all three forms of sexual exploitation. They saw women with mental illness as most exploitable, but the trend held for men as well.

A critic might rightly point out that these studies only showed that people with “an illness” are seen as exploitable. It could just as well be a physical illness. So, the final step was to show that perceptions of exploitability are higher for mental illnesses such as bipolar disorder and bulimia than physical illnesses such as asthma and diabetes. The results showed that, at least in terms of perceived exploitability, physical illness was no different from being healthy. People only saw individuals with mental illnesses as relatively easy to deceive, pressure, and coerce into sex.

It’s Not Just Sex

Reconsider the story about psychiatric patients being exploited for sex. Would it be any less believable if the patients had been physically abused? Or if they were bullied into handing over money? I think not.

After looking at perceptions of sexual exploitability, I conducted follow-up studies to show that people also perceive individuals with mental illness as easier to abuse, cheat, cuckold, and kill. It turns out that the perception of people with mental illness as exploitable is broad, not sex-specific. This is consistent with real-world statistics. People with mental illness face an increased risk for a variety of crimes ranging from rape to battery to theft.

Theorists have long considered mental illness a “double problem.” People struggle with the symptoms of mental illness, plus they are stigmatized for having a mental illness. Unfortunately, it may actually be a “triple problem” because people with mental illness are also seen as exploitable, and this could add victimization to lives that are already so often characterized by stress and trauma.  


For Further Reading

Boysen, G. A., Axtell, E. L., Kishimoto, A. G., & Sampo, B. L. (2021). Generalized perceptions of people with mental illness as exploitable. Evolutionary Behavioral Sciences. http://dx.doi.org/10.1037/ebs0000267

Boysen, G. A., & Isaacs, R. (2022). Perceptions of people with mental illness as sexually exploitable. Evolutionary Behavioral Sciences, 16(1), 38–52. https://doi.org/10.1037/ebs0000194
 

Guy A. Boysen is a Professor of Psychology at McKendree University. His scholarship emphasizes stigma toward mental illness, the teaching of psychology, and the professional development of faculty. 

The Hurtful Consequences of Empathic Shame

When rape survivors tell people about their assault, they all too often face unhelpful and even hurtful reactions. Law enforcement may doubt them, healthcare workers may blame them, colleagues may shun them, and even close friends and family may avoid them. It’s difficult to overstate how devastating these reactions can be. Research suggests that negative reactions like these increase posttraumatic stress and depression, and hinder survivors’ recovery.

But why do people so frequently treat victims of sexual assault poorly?

My research suggests one powerful and surprising predictor—empathy.

Over the last decade empathy has become a buzzword. There are currently over 2000 books on Amazon.com with the word “empathy” in the title. Pundits, politicians, CEOs, and celebrities alike encourage people to be empathic, a trend that is evident in the many social media hashtags such as #empathymatters. While empathy-skeptics exist, research generally indicates that empathy is a psychological force of good in society because it normally increases helping behavior. However, whether empathy leads us to treat others well, or to treat them poorly, may depend on which emotion is evoked within us when we empathize.

Empathy can work in two different ways to trigger an emotional response. Sometimes we feel as others do. That is, we reflect the emotional state of another person in a mirror-like way. For example, if someone else feels ashamed, we will also feel ashamed. On the other hand, sometimes empathy leads us to feel for others, which is still an emotional response but not necessarily the same emotion the other person was feeling. For example, if my friend feels ashamed, I might feel concerned or angry at the person who made my friend feel that way.

There are a huge variety of emotions one might feel when a friend or acquaintance discloses that they have been assaulted, but here I will focus on anger and shame. I am focusing on these two emotions because previous research indicates that these emotions change how people respond to rape survivors. Anger is a motivating force for action; if we feel anger when our friend tells us they have been raped, we are more likely to stand up and do something about it. On the other hand, shame is a paralyzing emotion. If we feel shame, we are more likely to withdraw and distance ourselves from other people and the source of our shame. Shame may lead us to treat rape survivors poorly as we try to place physical and psychological distance between ourselves and the source of our shame.  In terms of rape disclosure, if people directly reflect the emotions of others they may be more likely to reflect a rape survivors’ feelings of shame, which is a very common emotion for survivors. Conversely, people who tend to feel different emotions may be more likely to feel anger on behalf of a rape survivor, and therefore be more likely to offer to help them.

In a recent research study, I attempted to predict how people would treat a hypothetical rape survivor. I did this by measuring people’s habitual empathic tendencies and what emotions they felt in response to a hypothetical rape disclosure.

I asked 282 American men and women to complete an online questionnaire called the Interpersonal Reactivity Index that measures empathic tendencies. I then asked these participants to read a date rape scenario involving a female victim called Kathy and report how they felt afterwards. Finally, I asked participants how much they blamed Kathy for her assault, how much they would distance themselves from her, and whether they would offer to help her.

Sadly, all too many participants indicated they would blame and distance themselves from Kathy. But—how people reacted could be predicted by their empathy and emotions.

Whether participants were likely to help Kathy was the easiest behavior to predict, with distancing intentions and blaming less so. People who reported tending to empathize by feeling different emotions were more likely to offer to help Kathy, and less likely to blame her or want to distance themselves from her. These helpful intentions were the result of feeling more anger and less shame. In contrast, people who said they empathize by reflecting other people’s emotions were more likely to treat Kathy poorly and less likely to offer her help. These hurtful intentions were the result of relatively more feelings of shame and less feelings of anger. It seems likely that participants’ feelings of shame reflected the shame they assumed Kathy felt. But it remains possible that participants may have felt ashamed for other reasons such as feeling ashamed on behalf of their gender (Kathy’s attacker was a man).

Nevertheless, if empathy arouses shame within us, it can paradoxically lead us to treat others poorly. Empathic shame is likely quite rare and may even be unique to disclosures of sexual assault. In another study I used the exact same method, but had participants read about a robbery rather than a sexual assault. In this experiment I did not find any evidence that participants felt ashamed. Even participants who said they tend to reflect other people’s emotions did not report shame. It appears that sexual assault may arouse a unique constellation of emotions and has a higher likelihood of triggering empathic shame.

It would be good if we could reduce the negative consequences of empathic shame for rape survivors in the real world by limiting people’s exposure to shame. Anti-sexual assault campaigns that draw attention to the shame or humiliation experienced by rape victims may do more harm than good. For instance, depicting survivors in poses of shame (such as with a hand over their face or looking away from the camera) might lead viewers to feel shame themselves and subsequently unintentionally react in a negative manner. To promote more compassionate treatment of survivors, societal movements such as the #MeToo movement may be particularly effective. The #MeToo movement may serve to lessen the shame surrounding sexual assault by visibly demonstrating that many women have survived such attacks and providing judgment-free solidarity for those who have.

Overall, having empathy for rape victims is only as beneficial as the emotion aroused and the actions one takes. A better understanding of how empathy might lead us to hurt rape survivors via empathic shame can hopefully help us to prevent these reactions in the future.


For Further Reading

Martingano, A. J. (2020). Helpful and hurtful empathy: How the interplay of empathy, shame, and anger predicts responses to hypothetical rape disclosures. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260520922345
 

Alison Jane Martingano is a postdoctoral research fellow at the National Human Genome Research Institute, National Institutes of Health. Her research interests include empathy, communication, and the impact of emerging technologies on health.

 

The “Reasonable” Way to Respond to Being Sexually Harassed

In the cascade of sexual-harassment allegations now coming to light, a central question has emerged: Why did so few speak up before?

Research from psychology provides an answer: Many women feel complicit in their own assault and are ashamed that they did not react more forcibly at the time. Consider the experience of the actress Rachel McAdams, who as a 21-year-old theater student was lured by the director James Toback to a hotel room and pressured to take off her clothes. McAdams, now 38, kept quiet about the episode for 17 years. “This has been such a source of shame for me—that I didn’t have the wherewithal to get up and leave,” she told Vanity Fair.

Like McAdams, many people feel embarrassed that they “let” themselves be sexually harassed, and they keep quiet as a result. Yet according to research from psychology, finding the resolve to get up and leave is much harder in the moment than it seems after the fact.

study conducted at Boston College in the 1990s sheds light on this issue. Psychologists Julie Woodzicka and Marianne LaFrance asked nearly 200 women what they would do if, during a job interview, they were asked questions like, “Do you think it is important for women to wear bras to work?” and “Do people find you desirable?” These questions were chosen because they were clearly sexually harassing.

Most women thought they would be angry and confrontational if an interviewer used these lines on them. They said they would storm out, tell the interviewer to shove off, or, at the very least, refuse to answer his inappropriate questions. Some said they would report him to his supervisor.

But what do people do when actually subjected to sexual harassment? To find out, the researchers placed advertisements in newspapers and posted fliers around campus advertising a position as a research assistant in a psychology lab. They recruited 25 women to come in for what appeared to be a job interview. The researchers trained a male actor to pose as the interviewer and to subject each woman to the sexually harassing questions. The researchers covertly videotaped the interactions.

Continue reading the post by visiting Behavioral Scientist.


Roseanna Sommers is a joint-degree student pursuing a J.D. and Ph.D. in psychology and law at Yale University. She seeks to understand our intuitive folk theories of morally and legally salient concepts such as consent, voluntariness, and autonomy.