A Little Help For Our Friends
A Little Help For Our Friends
Interview with Dr. Erin Berenz: Navigating sexual assault, trauma, and healing
The #MeToo movement raised awareness of just how common sexual assault really is. Unwanted sexual contact can have devastating consequences on the victim's life through trauma symptoms that show up at work, at home, and in love. In this episode, Dr. Erin Berenz (associate professor at University of Illinois Chicago and co-founder of Rebound Health) unpacks the intricate and often misunderstood aspects of sexual trauma. Dr. Berenz sheds light on the challenges many face in practicing consent, especially when grappling with societal pressures and internal conflicts. We delve into the psychological impact of these dynamics and the struggle for survivors to reconcile their experiences with their personal narratives and trauma. We also explore the theme of control in the context of trauma, particularly sexual assault, and the physiological responses that occur during these harrowing experiences. Learn about the long-term effects of trauma, including the heightened risk of PTSD, and various treatment options available.
Resources:
- The Rebound app for Apple devices for self-help for sexual trauma
- If you struggle with supporting a loved one with sexual trauma, check out KulaMind or fill out this interest form to learn how we can help.
- If you have a loved one with mental or emotional problems, co-host Dr. Kibby McMahon can help. Kibby's coaching program KulaMind offers individual support on demand, skills and resources to help people care for loved ones with mental illness. She only takes a select few clients at a time, so apply here if you're interested. Listeners of the podcast get a special discount! Contact her at kibby@kulamind.com to learn more.
- For more info about this podcast, check out: www.alittlehelpforourfriends.com
- Follow us on Instagram: @ALittleHelpForOurFriends
Welcome back, little Helpers. Today we have a topic that is so overdue I kind of can't believe we haven't brought it up yet, but I'm kind of also glad we didn't, because we have a guest here today that is much more knowledgeable on this than I think we are, and that is Dr Erin Behrens. She is an associate professor of psychology at the University of Illinois, chicago, and co-founder and chief clinical officer of Rebound Health, and she is here to talk with us about sexual trauma. So, erin, welcome. Thank you for coming to school us today, and can you just tell us a little bit about your expertise for this topic?
Speaker 2:Yeah, thanks so much for having me. I'm excited to be here. It's an amazing podcast. Yeah, so I actually have for ages been a professor of psychology at the University of Illinois, chicago, and my whole career has really been focused on understanding why do some people struggle after trauma and others don't. And a lot of my work has been among survivors of sexual assault, and so I've done a lot of, like you know, trying to do a lot of education about getting good treatments out there, figure out how can we get them into more people's hands and ultimately realize that stepping away from academia was the best way to do that and co-founded Rebound Health with Reva Kumar, who is herself a survivor of assault, and we made a trauma recovery app called Rebound, available now in the Apple App Store you can try it for free if you're interested but really kind of taking all of the years of research and education that I've had and trying to put it more into people's hands so they can, you know, have the best shot of recovery after going through something like this.
Speaker 1:You have big impact stepping away from. I know so weird.
Speaker 2:I you know I thought people might read my scientific journal articles but you know, probably like my five best nerd friends, yeah, not the most engaging outlet.
Speaker 3:Erin, what's um? What is sexual trauma?
Speaker 1:I mean like or sexual assault, because yeah, I feel like this is going to open a discussion about how the nuances of sexual trauma are what caused half the problems.
Speaker 3:Right Cause like yeah, even just trying to define it or think about what it is, it's like so many people have had unwanted sexual experiences or negative ones or ones that made them uncomfortable, and how do you know when something is like a capital t trauma and might lead to trauma symptoms, versus like a bad experience.
Speaker 2:That's a hard one to say.
Speaker 3:What is sexual trauma?
Speaker 2:Because, like there are just awkward sexual experiences and what we're talking about here is something a little bit different. But I think you know, even with this being an area focused on for years and years now, like I come across stories that are in this like murky area, and so I think you know it really is kind of a tricky subject. Broadly, I think of sexual assault as any kind of non-consensual sexual activity, and so it's not just penetration but any, you know, unwanted touching, kissing, grabbing, anything of a sexual nature would kind of fall into this category. Um, but there definitely are, you know, a lot of tricky uh lines that it's just you know, it's just hard to draw.
Speaker 1:Well, yeah, I mean I think like having a discussion around this makes a lot of sense. I I one thing that has been really interesting as a cultural development lately, especially with the Me Too movement, has been kind of illuminating how ambivalent consent can sometimes be and feel and how that can really confuse women and men about like, is this a consensual experience or was that assault?
Speaker 1:I know I've certainly been in multiple situations like that. Um, and how you know, women are often people pleasing and don't feel like they can say no, or they feel an immense amount of pressure to say yes, and so then it can feel murky whether they consented or not. So, I don't know if you're thinking about examples like that, or.
Speaker 2:Absolutely Like. I definitely think you know, in general, like best case scenario, consent is not a passive process, it is an actively sought thing. And so if you are in a situation with somebody you know, I think best practice would be not just to get consent at the beginning, and certainly not to take silence as an indicator of consent, but just to frequently check in and make sure that what's happening is something that both people want. And I think that the reality is that's really hard to do in practice because people feel uncomfortable or not quite assertive enough or like people pleasing, like you're saying. So I think, like in practice it's really really hard to do that. But, like, I think the gold standard should be like both partners really checking in with each other and, you know, not assuming that consent at the beginning is consent every step of the way. Consent is not like a one and done kind of thing. But you know, I think I think that is really tricky.
Speaker 2:Yeah, I had some. You know I did have some thoughts about this like so the part of it is like you can consent to, let's say, kissing and touching or something like that. That doesn't mean that like if somebody's into it to one activity they're going to like kind of be into taking things further. But it can also mean like maybe you've started having sex with somebody and partway through they decide that they're not okay with it anymore. Like it can change moment by moment. And so many women I talk to have like had this happen where they consent to like some degree of sexual activity but then no longer consent to what's happening and and that you know that can fall under assault. Like where consent is sort of taken away and the person doesn't listen, doesn't hear them.
Speaker 2:Yeah that to me, will qualify as assault. Yeah, it's tricky. I think another I mean this is kind of a classic one I think in 2024, more people are aware of this idea that, like you know, sexual assault isn't something just perpetrated by a stranger. Like you know, sexual assault isn't something just perpetrated by a stranger. I think this is one of the most common kind of confusing things that comes up with assault too, is that if you're assaulted, chances are it's by somebody that you know and trust and you can know that statistically. But then when it happens to you, it just like completely throws you off. So I think that we're past the point of like the stranger in the bushes being like the person that we think is going to assault us, but it's really like probably even more than people realize it's like 80 to 90% of assaults are perpetrated by someone that you know. So you can rest assured that you're like less safe with people you know well, which is kind of a scary thing, and you can know that statistic. But then if it happens to you, like your brain just it's like this mismatch in your brain, like your brain has trouble connecting the dots that this person that you know and trust like did this horrible thing to you? And there's this like you know thing we think it was like cognitive dissonance, like one of these like this, either the belief, like some belief, has to shift here for this to make sense and the easier thing, I think, for most women in particular, is to think well, that must not have happened to me, this must have been my fault, my failing like, my lack of communicating. This was an assault, this couldn't be assault, because they wouldn't do that to me. This happens really commonly with women in college, where we've got like something like 20% of college women will experience at least one sexual assault during those few years.
Speaker 2:So there was this story that I you know obviously not going to give away details of who this is, but a story that I had heard from a young woman a handful of years ago who was at a party with a group of her friends. There was a male friend that she kind of you know, knew and trusted they weren't even dating or anything like that. He ended up sort of seeing that she was intoxicated, had her go up to a bedroom, came up with like some excuse to get her to like go away in private with him, locked the door, took her phone away from her, was treating it like a game, sort of holding it over her head, put it out of her reach and ended up sexually assaulting her. And she felt so confused as to like, well, how did I let? How did I let him get me in that room? Like how did this happen? Like I must have done something wrong.
Speaker 2:This was somebody I know, this is a friend and really was struggling to kind of make sense of what happened. And you know, not only because she knew the guy, but also because she, you know, there was alcohol involved, which is another sort of frequent, confusing thing that happens.
Speaker 3:Take us through, then what tends to happen after that? So like, do you see some common like steps that happen or things that happen to the person? Like they start to blame it on themselves and kind of like shift their thinking there. But then then what are they in shock after, do they?
Speaker 2:Yeah, I mean definitely, you know, in a lot of cases in college, like sometimes it's even just piecing together what happened, like if somebody had been drinking and had been like targeted by a perpetrator because they were drinking, like that's a whole other layer we can get into if you want. But if you think about like you're more likely to know somebody who assaulted you, then also I think the part we don't always consider is that your social support network is likely to also know your perpetrator. And then you know, thinking about the environment in college, like you know, social networks in college, I would say the large majority of college women in particular who I meet, have maybe never told anyone what happened to them. They don't disclose to friends, they don't want to make their friends choose sides. If they do disclose, sometimes they lose a lot of friends in the process and that can be incredibly shaming and isolating too. So I would say a classic way that this looks in that age group in particular is that they, you know, start to withdraw, don't want to come in contact with a perpetrator, and sometimes that means not seeing their other friends too.
Speaker 2:Also, it makes it hard to, you know, go to class, do your studies, because you might run into that person on campus. I think you know I'm class, do your studies, because you might run into that person on campus. I think you know I'm bringing up college, just because it's like it's such this like bubble, that like your whole world is like kind of shaken up. So you know, you're kind of like left with this like emotional aftermath, while the perpetrator is just out living his life, doing his thing, hanging out with your friends. There's a lot of shame, a lot of guilt, a lot of just feeling sort of broken. For a lot of people, I think their whole life course can kind of shift after something like that happens.
Speaker 1:This has to be one of the most confusing traumas for so many reasons. There's the ambivalence about consent that can happen. There's the fact that this can be one of the only like traumas that's pleasurable. And you know, if it's pleasurable, what does that mean? Does that mean you enjoyed it? Does it mean you wanted it?
Speaker 1:Does that, you know, like I mean, I had an experience where I had like passed out drunk in a bed with a friend and her boyfriend and I'm like woke up to him touching me, but like it was pleasurable, I didn't stop it fast enough, and so then it was like I was like felt a lot of guilt about that and like I had betrayed my friend. And still very confusing, um and like multiple experiences of saying explicitly I do not want to have sex tonight, and then being like okay, and then 10 seconds later pushing into me, and then half the time you've been like, okay, well, I guess we're doing this now, so I'll enjoy it. And so then it's like how do I categorize that? Yeah and so yeah and so kind of, but not feeling like that was an attack. And so how do I wrap my head around it?
Speaker 1:you know, I was kind of looking for like what was my part in it. And it's weird, being a psychologist and and knowing how I would approach it as a therapist, but not feeling that way.
Speaker 2:Oh, yeah, we are much more clear headed with other people's experiences that are, oh, and that's for sure, yeah, I'm really sorry that that happened and it's like so common, and I I'm really glad that you brought it up, cause I think that's like a layer that a lot of clients even, um, you know, like aren't aren't comfortable, aren't comfortable bringing up. And I'll have to like often, like sort of probe for that or sort of look for it, um, and the way I approach it with like clients, especially as thinking about like the difference, you know, like what is what is sexual arousal, what is pleasure? Like there are, you know, a couple of components like there's the physical piece of it and then there's like mentally, how we're thinking about it and viewing it, and those aren't always on the same page. And so I um have definitely talked to many women who experienced, uh, like physical arousal at some point during an assault, even to the point of orgasm, for a completely non-consensual and sometimes like violent or rough encounter, and that can be so confusing, you know, and I think a lot of women end up feeling kind of betrayed by their body when that happens too, because it, you know, their brain might be screaming like I don't want this, like in the more extreme cases, and then, while their body is physically responding, like that can happen, and so I do.
Speaker 2:You know, I try to do a lot of educating around the difference in those so like your body responding is not the same as you consenting, and it's not even the same as you enjoying it in the way that you would ideally enjoy a sexual encounter, and so I think that's that's a big thing, you know. I think the harder question is, like that gray area, like you're saying, is like you, you kind of you know these situations where you're like I actively am saying I don't want this, it's happening anyway, and so I just, you know, I might as well. You're like I actively am saying I don't want this, it's happening anyway, and so I just, you know, I might as well give in, like you know, I don't know that, that kind of you feel free to tell me too. Like I wonder if that's partly your brain trying to say like this isn't you know, let me, let me make this so it's not assault, let's make this like so that it fits a little more neatly, or I, I I'm feeling like I have some agency, I'm getting back.
Speaker 1:Um, you know, I don't think it means necessarily that you wanted it to happen, but Well, I think what made it very difficult for me for a long time was being raised with beliefs Like if I have sex with a man too soon, he won't call um, I'll devalue myself in his eyes and society's eyes. Whatever, like every time you have sex with somebody new, you you lose in a way, like you lose some degree of power. And so me, you know, maybe in a situation where I otherwise would have wanted to have sex, I have all of this running in my head of like I can't feel comfortable with this because I know that I will regret it. Or like I know that I'll lose something essential here. And so me saying, like I don't want to have sex, that wasn't my body saying it, it was my, it was all these narratives saying it. And then him just completely disregarding that was really went along with that narrative, like, oh, you're right. Like as soon as I'm in a sexual experience with you, you devalue me, and so that's what's happening even further.
Speaker 1:And so, okay, like, yeah, I guess I guess we're doing this now, like I've already lost, so I might as well like not put up a fight or or not make this unpleasant, and it's a. It's an experience where, like the act itself isn't horrifying. It is, with certain sexual assault, obviously, but like these situations it wasn't horrifying. It's not like I was being hurt, it's like physically. It's not like I was terrified, it's this kind of like oh okay, I guess I just I guess that's how little I mean. Well, I guess I'll have to deal with that tomorrow. And that makes it kind of confusing, like, like, is that really traumatic or is that something I can just sort of deal with cognitively and let go? Or yeah, is this just a confirmation of my narrative like, what is this exactly?
Speaker 2:yeah, I think you're highlighting like a big issue in our society, which is women being put in the position of being these like moral gatekeepers of sex and being in the position of like in the first place, having our self-worth, our morality, our attractiveness as a long-term partner like wrapped up in this like kind of virginal narrative, whereas men are just kind of able to do as they please try to get as far as you can. You know that classic like more is more, you and he would have been like kind of raised in very different ways in terms of how to think about that scenario him like trying to get as far as he can, and you oh, it's my job to like be the one to regulate this, and if I fail, it says something about me, not about him, not about the interaction, but about me and it gets just really kind of messed up.
Speaker 3:Speaking about that control piece, which is like it's interesting because control in trauma is such a big thing and like, what can you do? What could you have done to control and and stop what happened? And what can I do to control and stop it happening again? I remember you know people who have been through that. They do wonder like, oh, I should have not gotten drunk that night, I should have not wonder. Like, oh, I should have not gotten drunk that night, I should have not gone with that person, I should have not Right. And it's hard to argue because it's like, yeah, those things were all choices, right. And how do you navigate? Talking to patients or survivors of sexual assault about that question of like, what could I have done to stop it?
Speaker 2:Well, I think there's like I mean, it's like that's a huge question, a really good question. There's a few kind of angles that I think about this. One is that, in a lot of ways, when something traumatic happens to us, whether it's a sexual assault or some other kind of trauma, we are not really in control of our bodies. We, you know, there's this very kind of like control of our bodies. We, you know, there's this very kind of like what's the word I'm thinking of? Like caveman style, I mean where are you?
Speaker 2:finding. Yeah, there, I mean, there's this like fight, flight, freeze kind of thing that happens. That's just like evolutionarily derived, Like when you're in danger or when you're in a traumatic situation. You're not like calculating. Here's what I'm going to do your archaic part of your brain is taking over to try to keep you alive and keep you safe, and so I think I see the most guilt when people have this kind of freeze response. You know, in extreme cases people feel like they literally cannot move. But we aren't choosing how our brain responds and most people's natural response, especially women, is not to fight. Like that is not kind of the go to that most people experience. But there is this like intense physiological fear response that happens. It's designed to keep us safe and sometimes it's not the right thing in that situation, but like we didn't choose it, it's not something we have control over.
Speaker 2:I think on the drinking front, like that's a huge one, like drinking or using other substances and then being assaulted the tendency is to blame the woman, Like I think about.
Speaker 2:Like that Brock Turner case at Stanford, like you know, a handful of years ago at this point, where you know he was a star swimmer, he was drunk where he was a star swimmer, he was drunk, this young woman was drunk and he sexually assaulted her behind a dumpster when she was blacked out and there was a lot of debate around was this her fault? That's nice, oh, it's real nice, yeah. And there was a whole trial like trying to pick apart like her drinking behavior, like how much is she to blame? It's not his fault, all this stuff. So I think there's a lot out in society that perpetuates that kind of thing too. But there's actually some really interesting research that's been conducted among young adult male perpetrators of sexual assault and somehow these researchers got these guys to like get really candid about like how, like how do you go about this, Like how do you choose, like, who you're going to assault, and so you know. I don't know how they did it, but these men were just like opening up, telling everything.
Speaker 1:The kinds of stuff.
Speaker 2:Oh my gosh, I'll find it and send it to you. It's kind of a more qualitative study, pretty small sample, but really I think, really eye opening. But there there are men just kind of explicitly saying yeah, I, if I see a woman who's drinking, I will try to get her to drink more. I will look for someone who's drunk because I know they'll put up less of a fight, and so it's. You know, this isn't guesswork. Like men who are doing these things are saying, like they are choosing the person who they think is in the most vulnerable position. And so why? Why should it be our job to not be vulnerable instead of their job to like not be predators?
Speaker 1:it makes it makes no sense so they weren't showing any kind of like these were people who were actively doing it. Were they in prison? They weren't showing any kind of remorse.
Speaker 2:I'll have to find the study, so don't hold me to this 99%. Sure these were men in college reporting sexually assaulting women.
Speaker 1:I just I can't be. I will let you jump in in a second. I just like can't. I just I can't be. I will let you jump in a second. I just like can't. It is just the height of entitlement to just think, like you know, I'm horny so I think I'm going to abuse another person. I just I think that's what I deserve to do. You know, like I think I deserve to put my penis in them. That's what I'm going to do. It doesn't matter what they think or feel like that's that's what I need to feel better, and I I think maybe a lot of women can't even conceive of that kind of entitlement, so it just doesn't compute. Yeah, I don't know, kibbe, sorry, I knew you were trying to jump in.
Speaker 3:No, I mean I, I along those questions like who tends to be perpetrators of sexual assault? It must be, as you were saying, like if you are sexually assaulted by someone you trust and know, then your brain has to do some jumping, jumping jacks around, like is this person, is this normal behavior? Is this my fault? Are they a bad person? And if they were a bad person, how did I not see it until now? Right? So is there any? Or is it? Is it like it's just what guys do quote, quote, like is it? Is it something about nature? Nurture who tends to sexually assault?
Speaker 2:Is there no way of telling yeah, and I'm going to be. I want to be real careful here because this is definitely not my area of expertise, but it's I'll be. I'll try to like stick to the things that I do feel more confident about. I don't mean to focus only on college study. It's just where so much of this research has been done, because it's this discrete period of time where this stuff is happening at crazy proportions. But it does tend to be a small number of men who perpetrate multiple times. So it's not this thing that like oh, this is what all men do.
Speaker 2:Most men do not sexually assault women. Another explanation I hear frequently is that, oh, it's because they were traumatized, they were abused themselves. That must be why they're doing it. But the research does not support that. In fact, you know, if you, if you look at trauma exposure in childhood as a risk factor for things in adulthood like in the vast, vast, vast majority of people who have been through assault or trauma themselves are not perpetrating against other people. So that explanation doesn't hold up. My hunch would be that the reason a lot of perpetrators of violence have violent histories themselves is probably because there is a piece of this that like runs in families right, like if you inherit some amount of this like tendency towards this sort of like behavior. That's unacceptable. You know you're probably around people in your family growing up who also have those. Those traits are more likely to have those traits. I'll keep it that broad because I'm not really so up to speed on on the literature there to like jump in a whole lot further.
Speaker 1:But yeah, yeah, I think one of my. So at first the Me Too movement, I was like seeing a lot of the excesses, cause I hate cancel culture, but then I think it did so much good. And one of my favorite, my favorite story from the Me Too movement was the Aziz Ansari one, because it was really nuanced and, I think, pointed out a lot of the cultural factors that led to what happened. Um, so it wasn't this just cut and dry. I mean, obviously we needed to know about Harvey Weinstein, his, you know, demonic behavior, but I really appreciated how the Aziz Ansari story showed a lot of different factors.
Speaker 1:Like Aziz was clearly going for the not know, you know, not be enthusiastic, yes, and it seemed like in many ways he was doing the things that men I had gone out with were doing, which was just like, all right, I'll wine and dine her and set her up in a situation where then she's entitled to give me, like, like I'm entitled to get sex from her. Yeah, like very transactional, yeah, very transactional in again and and you know, see if I can write the ship for my benefit, yeah, and clearly him not thinking he's done anything wrong, because I guess that's just the setup for men on dates, like maybe that's just what they thought. And it's kind of amazing when I think about like that attitude.
Speaker 2:Yeah, it's super unrelatable with the way society brings us up.
Speaker 1:Well, right. And then you can see that in on her side where she's just like, wow, I was really excited to go on this date. And the more things slip sideways, the more I want to fix that dissonance. And okay, I'll just keep going and see if it gets better and like, see if I can position it for my benefit, like maybe this is romantic, maybe there is an actual connection here. Oh no, okay, well, maybe if I wait a little longer. Okay, well, now, I don't now something. I'm in a situation I don't like, but I don't know how to speak up and I keep trying and it doesn't really work.
Speaker 2:Yeah, Well, and the power differential would have been there. You know, male celebrity, lots of money. You know, anytime there's that like power difference, that ability to say no, it's just harder and harder.
Speaker 3:Yeah to say no is it's just harder and harder. Yeah, yeah, what? What do you see? Um, are there like the typical trauma symptoms from sexual assault?
Speaker 2:Um, if anything is different from like other kinds of trauma or ones that are like common, I would say like across the board, as opposed to like different types of symptoms, like the most notable thing is that the symptoms are just much more severe after sexual assault compared to other types of trauma. So I think the biggest takeaway is not that like, oh, it's so different, but your likelihood of having trauma symptoms like PTSD after a sexual assault is just so much greater than other kinds of trauma Interesting. So there there are studies published, for example, showing that and this study I'm referencing was published by some researchers at the VA, actually showing that women civilians are more likely to have PTSD than male veterans, and a lot of the reason for that is because we're more at risk for these really high severity traumas like sexual assault, high severity traumas like sexual assault. And so there was this other you know I'm just going to go full nerd on you there was this other recent meta-analysis of what's the likelihood of developing PTSD after sexual assault. So meta-analysis for people who are not like steeped in nerdery like I am and you both are, is, like you know, like kind of combining a bunch of studies so that we can be like even more sure of the results. So if we can like get more people and more findings. Together we can be more confident. And this study was conducted by Emily Dworkin, a friend and amazing trauma researcher, and some of her colleagues, and they found that 75% of people who experienced sexual assault will meet criteria for PTSD one month after the assault and at one year after the assault, 42% will meet criteria for PTSD.
Speaker 2:Even me, being a trauma researcher again who's like been around for a while, I just like still felt shocked by that, and so I think that's the biggest thing is like the need is out there, like if people know someone who's been through this kind of experience, especially recently, like chances are they really need support and help. I think that's a big, big takeaway. Don't assume that people just kind of get over sexual assault quickly In terms of specific symptoms. This is kind of more my clinical judgment here, but I think some of the biggest stuff which isn't surprising it's just like a change in sexual behavior and interest. So if you're sexually assaulted, any kind of sexual contact can like trigger your trauma memory and can make it really hard to have like a healthy relationship with somebody. So you know it's not just feeling afraid at sexual contact but maybe like disgusted or just you know, a range of emotions can come up and so that, yeah, I can just make it hard to like have normal relationships, like go on, get married, have kids, do all that whole thing. You know time out, pregnancy and childbirth after sexual assault that's a whole other topic.
Speaker 2:But there also can be sometimes an increase in sexual behavior which I think can be confusing to some people. So you know, if any of your listeners have experienced that like, no, that's incredibly normal too, and so a lot of times that's like kind of an indicator of, like, your relationship to your body just changes after assault. So maybe you don't feel like you're in control of your body. You know again, if you were somebody who had like physical arousal during an assault, maybe you feel like your body betrayed you.
Speaker 2:But there could just become this real disconnect between, like, brain and body in that domain. Sometimes you just feel like completely unempowered to set sexual boundaries. Maybe you, you know, your brain has learned this is what men want for me. This is what people want from me. If this is all they want from me, let me use this as a tool. Let me at least get something that I want out of this. There are so many ways this can look. So what I'm saying isn't like kind of, you know, the same thing for everybody. So yeah, I think if sex, if your interest in sex goes way down or your engagement in sex goes way up, either of those can be really normal after sexual assault.
Speaker 3:Like this is so, this is so sad. I mean, I just it's just so common that it's just like I thought being like a women in your twenties was all about. But what, what can we do about it? Like, how, how good are the treatments out there? How difficult is it to find. How effective are they?
Speaker 2:So I feel like I, you know, have been a bit of a downer on the show so far with like here's all the bad stuff, Like the good news is there are.
Speaker 1:Yeah, that was.
Speaker 2:I mean the topic of the show. We're only going to be real about it. But the good news is that there are treatments out there that work, and I I feel the need to say that all the time because I think there's a huge myth out there, um, just in in popular media, that, um, trauma recovery isn't a thing, or it's a lifelong process or you can't actually get better, especially if you've had, like repeated traumas. And thankfully that's not true. There are good treatments that, um, you know, if somebody has PTSD they go through one of these therapies. For 80 to 85% of them, they won't have PTSD once they get through the treatment. So stick with it, find a treatment that works.
Speaker 2:All of the treatments that have these kind of results are forms of cognitive behavioral therapy, so looking at changing thoughts and feelings and behaviors around trauma, and these kind of fall into two camps. One is really focusing more on looking at how, like, your beliefs and your perception of yourself and the world have changed after trauma. Finding, like, what are your stuck points, the things you're hung up on, that you just like your brain struggling to move past because of your assault. The main one's called cognitive processing therapy. It can be really hard to find providers that do these treatments. I think that's the biggest struggle, but thankfully there are, like emerging some like self-help versions of these. So there's a cognitive processing therapy self-help workbook that's available on Amazon. I can send you guys the link to it. Um, it's published by like the best of the best, who who kind of therapy, and it's really wonderful. The other camp of this therapy is more focused on processing your traumatic memories, and so it's a really emotional thing to go through this kind of therapy, because you have to activate those memories, to kind of move through them, to make sense of them, and you're basically retraining your brain to feel safe when you think about what happened to you.
Speaker 2:So there are a few therapies that take this approach. I think EMDR is the one that most people have heard of. Prolonged exposure therapy is another, and there's research showing that. You know, if you're not able to find a therapist who does this, there are self-guided versions of this that you can do on your own. And so Rebound, the app that we made, is taking this approach helping you on your own through an app, learn about trauma, learn about your brain and body and how it's changed. You know, get your brain out of emergency mode by processing what happened to you, and so I can definitely like share links to both of those things and also to. There are a couple really great resources I like to share with people to. One is through the American Psychological Association. They have a little overview of like the best supported treatments for PTSD. The VA has great resources online even for non veterans understanding trauma and PTSD and treatment a little bit better. So I think those are really great educational tools as well.
Speaker 1:Amazing. I did want to just ask quickly because I feel like we've had a big focus on women who have been assaulted. Do you know, are there differences in the experience between men and women who have been assaulted? Are there differences in the experience?
Speaker 2:between men and women who have been assaulted. I'm not aware of major differences. I know it can be. You know, I know that men who have been through this kind of experience often feel really isolated and alone because I think it's just there's even more stigma. Speaking up For a lot of men they've experienced a sexual assault in childhood would be more common than in adulthood, whereas for women it tends to be, unfortunately, kind of both like along the lifespan, and certainly men or any members of the LGBTQ community are more likely to experience assault than their cisgender, hetero peers. So you know, definitely these. These are very real phenomena. I focus on women a lot of the time because it's just the numbers. It's overwhelmingly women. It's overwhelmingly, you know, sexual and gender minorities, but certainly, like any, you know, there are men out there who have in adulthood been sexually assaulted by women. It just happens less often.
Speaker 1:Well, in men who are, especially when they were children, who were assaulted by women, it just happens less often, well, and men who are, especially when they were children, who were assaulted by other men, which I think would be extremely complicated to wrap your head around. Um, because, there's the aspect of sexuality.
Speaker 2:Um, I think the worst, you know, the worst story that I heard along those lines was, uh, someone I had spoken to through one of our research studies, who did identify as a gay man but was sexually abused by someone who had claimed to be like sort of a mentor, advisor to him as he was in the process of coming out during adolescence. And so you know, thinking about the breach and trust and just like the abuse of like power and vulnerability in that situation I think of that not infrequently just how, how horrific that is.
Speaker 3:Hmm, what can you give us a snapshot of what treatment would look like, either through like rebound or a therapist? Because I can imagine a lot of people with trauma symptoms are afraid to delve into those things and think maybe if I talk about it or think about it, it's going to make me worse, right? Which is like a whole part of the trouble, right?
Speaker 2:Yeah, I think that's what a big myth is, and there are definitely providers out there who think I can't ask people about their trauma because I will make them worse. The reality is, anyone who's having an emotional response to being asked about their trauma they're already thinking about it every day. They're already having their brain taken over, flooded with these memories. You're not creating that or causing it to happen. You know, I want more people to feel comfortable talking to patients about trauma, not fewer people, and there actually have been studies showing that the level of distress people feel when they're asked about their trauma is very short term. So even if you get a spike in anxiety or negative symptoms, it's short lived and it will go away on its own. There are no data to support that like talking about or thinking about your, your trauma in a therapeutic, safe setting causes you to have a you know emotional crisis or breakdown or anything like that, and so that, I think, is really an important context to consider here. You know, I think the decision to work with a therapist around one of these treatments versus something like Rebound is like super personal. We definitely have a lot of members on our rebound platform who do both Like maybe they have a therapist to get weekly support, but then they like the structure of the app to guide them through sort of the treatment for processing their memory. But I think some of the things to consider when making that choice would be like do I feel ready to tell another person about what happened or do I need to work through this kind of in a little more privacy first? There are also some people who maybe had bad experiences with therapy and they want to work through it in a different way, and I can, you know, appreciate and respect that too. On the other hand, there might be people who are, like you know, feel so dysregulated when they think about what happened that they couldn't imagine going through like processing that memory without the support of a therapist or maybe somebody who, um, you know was is trying to maintain sobriety and worries about like relapse that they were to try to do this on their own.
Speaker 2:I think my biggest advice to people is just like, trust your gut about, like, what you need and where you're at, and to try your best to be the one in control of your, your journey. Like you know what you need better than me or you or anyone else. That, in terms of what it looks like, at least the the processing of the memory. I can tell you a little bit about how we approach it and rebound, which is how I went about it in my clinical practice, which I didn't make up. This is sort of based on decades of clinical research and the privilege of getting great training in this stuff.
Speaker 2:But truly educating people around, like what is trauma, what is PTSD, what are the normal reactions to trauma, some of the stuff we were talking about earlier in the conversation, like what tends to happen to people, like how they see the world and how they feel day to day and what happens in relationships. So giving a lot of education, a lot of education too, around how do our brains change? How do, how are we, how is our PTSD maintained by the way we react to trauma triggers and trauma memories? And why is it important to process the memory Again? To kind of get your brain retrained, to feel safe, feel calm, make sense of what happened you know, so you can kind of put it behind you. And so what we do is we guide people through talking through their memory bit by bit.
Speaker 2:We start really simple just sum it up in four sentences and say those out loud a few times While they're speaking.
Speaker 2:We have something called a story bubble that is just kind of gentle, it's like this orb that gently pulses as they're speaking and pauses when they're quiet.
Speaker 2:And so we instruct people to kind of focus their attention on this orb, to kind of stay grounded in the present and to kind of see how long to keep going until the exercise is over.
Speaker 2:So we start really simple and then each time they do a storytelling session they're asked to give a little more depth or a little more focus on a certain area, like what kind of went through your mind, what did you feel in your body, and sort of like, by the end of their journey. They're giving this very detailed, very comprehensive, like emotionally rich story about what happened to them during their, their traumatic experience. And they're also kind of processing, like you know what goes through your mind, like these different, you know reactions or thoughts you have about yourself, processing some of the meaning behind what happened, through little quizzes and exercises as they go. So it's really designed to like ease you in and this is kind of how it would be in person and therapy too, ideally, is like starting with something manageable and building from there until you're able to kind of like put the past in the past.
Speaker 1:One of the questions that I get most dumped on, when people reach out to me on Instagram, for instance, or friends get in touch, is like how do I find the right therapist? And this is an area where I would think that would be particularly important.
Speaker 3:Do you?
Speaker 1:have any tips on, like, if you're just starting, if you've been assaulted and you're noticing that you're really struggling, like, where do you, where do you go, what's your first step and how do you find that person?
Speaker 2:That is. That is such a tough question and so you know, depending on like kind of where you live, what your financial resources are, your insurance it's so, so, so tricky. So I think you know kind of thinking like layers, like first and foremost you have to find somebody you feel like safe and comfortable with that you can afford. Beyond that, like if you have the financial ability or the access to like choices in therapists which not everyone has, if you are fortunate and you have these resources to be choosy or picky, I would say to ask around a little bit. So you know, dig into some of those, some of that information on good treatments that like the APA or the VA offers, so that you have a little education of what to ask for. So supportive counseling is great, like we all want to be listened to and validated and heard. But that next level, if you actually want to work through your symptoms you have to be doing sort of one of these proven treatments I would say is like your first try. So, again, those will work for 80 to 85% of people. So like, if I'm thinking about it, like I want the thing that I've got the best chance to get better, so you could literally call a therapist up, send them an email and say like hey, before I come in for an intake, or like kind of share about my personal experience, I just want to make sure that you're like in a position to like give me the help I need.
Speaker 2:Like, do you do cognitive processing therapy? Do you do exposure? Do you do EMDR? How do you approach that? What does it look like? And just try to get a sense that they are describing what you understand that treatment to look like based on that reading. That is way more work than I want any person to have to do. Who's in that position, but I think that the reality is that's kind of what our system looks like right now. If you're really really lucky, you've got like a great, like really really tuned in like primary care physician or something like that, but I don't I it's hard for them to know everything about all of these.
Speaker 1:I know it's a big frustration for therapists as well, being like how do we? Because they're and not all therapists are created equal and not all therapists have the same training and level, like degree of training, and so it's always frustrating when I meet people who are struggling to find a good therapist or don't know how to find a good therapist, I don't know what to ask for. So thank you for that.
Speaker 2:When it's hard and, like you know, I do these treatments, but that doesn't mean I'm the right therapist for everybody. Like there are people out there who we and, like you know, I do these treatments, but that doesn't mean I'm the right therapist for everybody.
Speaker 2:Like there are people out there who we don't, you know, maybe they don't click, maybe I'm not the right fit for some other reason, and that's OK too. So I think, at the end of the day, like I can give you all the guidance possible about like these are the best treatments, but like each person kind of has to do what they feel is right too person kind of has to do what they feel is right too, yeah, yeah, well, the kind of.
Speaker 1:The last area that I wanted to talk to you about is what friends and family can do, you know, when their loved one has been assaulted. And, again, recognizing the complexity in this, you know, like I, I interviewed a woman who had been assaulted by her brother and cousin and they were there every single Christmas, you know, and it's like her family wasn't willing to dis, you know, disengage with her assaulters because they were their own kid or nephew. And sometimes people are very motivated to not blame the assaulter and just it just seems like there's so much complexity with this and the fact that people lose friends and are told not to report and all it just it's a rat's nest. So I just wanted to, I wondered if you could help us untangle.
Speaker 2:It is so true and I've talked to so many people in that position where you know it is a family member, a friend and and it's it's like some twisted version of a divorce where, like, people are divvied up, have to choose sides and not everyone chooses to support the survivor, and that's um, that's a challenge. So, like I'm going to approach this, assuming that whoever's hearing it wants to do the right supportive thing for someone, um, so if, if somebody that you know is disclosing you, telling you that they were assaulted, I think the most important thing to do is to listen to them. Don't try to jump in and fix it, tell them what they should do, don't make it about you and your emotions that you're feeling. So I think you know, first and foremost, kind of check your own emotions and and you know you can definitely set aside time to like, deal with them and process, like your, your emotional reaction later, but in that moment, keep your emotions in check. So it you know it may be that you have a memory of your own that gets triggered, or you may be reacting because you know the perpetrator or it's a member of your family, your friend circle. But Just hold back judgment, take the approach that what they're saying happened. Assume that it happened. Let them sort of share at their own pace. You don't have to push for a lot of detail. It's okay to sit in a little silence, but give them space to share as much as they want to and definitely validate any feelings that come up. Let them know that you hear them.
Speaker 2:I think it also can go a long way to thank them for opening up to you, because it's a really, really hard thing to do. A lot of people don't do that. Thank you so much for trusting me to tell me this. I'm here for you, and you mentioned reporting. I think it's definitely a personal choice.
Speaker 2:I think you know it's a definitely a personal choice, but I think a lot of people's tendency is to push well, we better call the police right now. And there there's a whole laundry list of reasons why that's not the right thing for everyone, um, not least of which is the, the, the stats on the small, small number of people who actually get persecuted, and the process can be, you know, for some people, equally traumatizing as the assault itself to go through the reporting process. Um, but just, you know, no judgment about what they should do from there, really just listen to them, um, let them know you're there for them and try to do everything you can to give them the control and the agency they didn't have during the assault. So, instead of saying, well, we better call the police right now, what would you like for us to do about this? How do you want to handle this right now, trying to put them back into the driver's seat, so to speak?
Speaker 3:Tricky question about that. What if you are, you have a partner who has been sexually assaulted and, um, I mean, I guess it's the same thing with any kind of loved one. But yeah, um, how do I say this? It could be tough, because it's like you, you also aren't getting your needs met sometimes in that, like if someone is shut down or someone is triggered or, um, you also have some. You like when you're saying, like, hold your emotions, like you also have to hold back your needs sometimes and look lopsided in those relationships. So what do you do if you're, if you're have a partner with sexual assault and you're kind of like walking on eggshells about that?
Speaker 2:Yeah, that is really tricky and I, you know, can. It can lead to a lot of tough feelings for the the partner who was not assaulted, you know, especially if they if just their presence or you know certain experiences or sexual contact, if that can serve to trigger their partner, you can end up feeling like you're being treated like a perpetrator, even though that's that's not how maybe you've been interacting in the relationship. So if that's the case, yeah, it can be really really tough. I think trying to have open lines of communication about like what's you know what's emotionally going on with the person, trying to be really patient, listening to them, hearing them, understanding what, what are they going through in the moment. I think couples counseling can be really helpful too, from a therapist who has experience working with trauma. The cool thing too is that there, you know, there's some research for approaches you know doing some of this, like CBT for PTSD symptoms that incorporate a partner or loved one, and so it may be like, hey, let's, you know, I know this is something that's going to take some time, but are you open to, you know, working through this in therapy, like I'm happy to be there by your side as you work through it May help them, like understand a little bit more too about why. Why is their partner responding the way they are in certain situations? I think, when it comes to like sort of a sexual relationship a hundred percent, like you know, being really open about like what each person's sexual boundaries are, are there certain ways of like touching or interacting that are more likely to trigger you or to like give you kind of a negative reaction. And if so, like obviously let's not do that, let's find other things that are more pleasurable for you. But kind of similar to what we were saying earlier, like kind of keeping the lines of communication open as far as consent goes to like if you get triggered, tell me and we'll stop right away.
Speaker 2:Like a lot of patients, a lot of giving agency and control to the survivor of assault, but then I think you know the, the stuff that's in the non-sexual domain, even as like the survivor may experience a lot of like emotional numbness, might dissociate. Sometimes um might feel like they're kind of far away, um, like they're not really focusing on what you're saying. Sometimes that can be challenging too, um, so I think just kind of gently checking in like hey, it's, you know what's going on. Are you having a memory right now what's happening? There could be issues with trust, all kinds of things. So I think, bottom line, trying to have patience, trying to have empathy, validating their feelings, but still trying to push to work through it together, like it doesn't mean that that's sort of what you need to accept in the relationship, because you do have needs to. So not like this is how it will be forever, but how can we work through this together? How can I support you in working through this?
Speaker 1:Yeah, I would never compare myself to like a rape survivor or anything like that, but I think with me it was just like a systematic reduction of trust in men and their intentions and like how they saw me as a sex object and, you know, had a relationship where I was like heavily guilted into sex all the time and my current partner is just so helpful in cause.
Speaker 1:I like to associate a couple of times when we had sex and he was very helpful and just like okay, situation ends now Like you have no guilt, I'm only doing this if it's for both of us, and then letting me be the initiator most of the time, which kind of allowed me to bring in my own agency and like, oh, I'm doing this because I want to, not because I'm obligated or because I'm meeting your needs or something like that. Yeah, and I don't. I'm not suggesting that is a one size fits all idea, but it was very helpful for me and being like okay, I'm connecting with my own desire now, instead of just saying I'm a sex object Like I always have been. So Well, it sounds like.
Speaker 2:I mean he sounds wonderful, but it sounds like there was a certain level of like conversation you must've had together about those past experiences, like an openness to like get to that place where he knew what's the thing you need. Yeah for sure, yeah, that must. I mean that's, that's like. That's a brave thing in and of itself to kind of like bring that in and yeah, I mean, I've always been pretty open and transparent.
Speaker 1:It's just like whether I actually believe. Like you know, I told a partner in the past and he would very much make it about himself and be like so angry that other men had done those things to me. But yet he was too, and it seemed more like he was upset that other men had touched me and so it was like, once again I'm being devalued for this having happened. Um, but, but yeah, my, yeah, jason's a. I see these boyfriends in my patients sometimes or I call them like therapy support boyfriends, therapy support animals, where they just like they make my, they like make my job as therapist so much easier because I know that my patient has somebody who's there and like does the interventions with them and is a point of trust, and that's what I have for myself. So very great yeah that's perfect.
Speaker 2:Yeah, it makes a huge difference, yeah, it does All right.
Speaker 1:Well, I'm so grateful that you came on and talked with us about this. It's definitely an episode I wanted to do for a long time and I'm really excited to go get really specialized training next year at the VA so that I can be more helpful to patients in this way. But just wanted to thank you for coming on and discussing this and also, when we were talking about how hard it can find a therapist, it sounds like you've created a tool that's really helpful for that. You know, if you don't have access to somebody who does CPT or prolonged exposure, um, or even if you do, but that's not the place you want to start, then we have this tool, yeah.
Speaker 2:Yeah, absolutely, I'm really excited about it. Um, the nice thing too is, if people aren't sure, they can try it out for free, um, it's not an Android yet, but in the Apple store it's available now. This has been such a great conversation for me too, like I'm the weirder that could talk about this all day. I do talk about this all day, every day, but I appreciate you guys having me on and, and having such a thoughtful, like in-depth conversation about it made me think about some things I haven't thought through in a while too and rebound.
Speaker 3:Your app is so. It's so great, it's it's so easy to use and it's really like simply laid out, like everything is just really easy to follow and to understand and I really love it. So we'll definitely link it to the website, but everyone should check it out. It's definitely a good app.
Speaker 2:Yeah, kibbe, you can say that, because Kibbe was one of our kind early test users who checked it out for us so we saw that the most basic it ever will be. It's great.
Speaker 1:Yeah, thank you so much. Okay, a little help for as well. If you enjoyed this conversation, please go on Apple podcast or Spotify and give us that five-star rating and leave a comment. Also, if you have any questions or comments about this episode or any other, please feel free to email us or DM me at Trampolina and we'll see you in a couple weeks.
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