Beyond Endurance

P1020950.jpgI believe her. I cannot imagine what sort of man-made hell (quite literally) she is now living through wherever she and her family are in hiding. I like to think of them as the trees pictured here are doing—embracing and supporting each other. From an ocean away, I can at least virtually support her.

I am, of course, referring to Dr. Christine Blasey Ford and her forced-to-go-public allegations of sexual assault as a 15-year-old at the hands (and body) of Trump-supported Supreme Court nominee, Brett Kavanaugh. Trump, and many male Republican senators, have publicly called Dr. Ford a liar. Would we expect anything different, anything better from men who excuse their own misogynistic beliefs and behaviors as mere locker-room boorish boy banter?

I do understand the long-lasting negative effects of surviving sexual assault. I understand the power of love, support, (good, woman-centric) therapy, time—and of telling one’s own story if and when one is ready to do so and when one is ready—in healing, in survival, in resilience, in endurance. In, as is used well in Indigenous Studies, survivance: survival/endurance or perhaps survival/resistance.

I wish for Dr. Ford and other brave girls and women in the world survivance and goddess-speed.

Trauma Mastery

IMG_0253Note: This is an excerpt from my essay “The Body Remembers” in my book Soul Stories: Voices from the Margins (San Francisco: University of California Medical Humanities Press, 2018).

Early in my career as a nurse, I worked for a year in a “safe house” emergency shelter for women who were escaping intimate partner violence. Before my work there, I did not understand the concept of trauma mastery and how this plays out in the lives of women caught up in the cycle of abuse. I sided with the common misperception that the reason so many women return to their abusive partners is because the women are psychologically damaged and weak.

I learned that there is the not-insignificant role of addiction to the thrill of trauma and danger—to the effects of the very activating yet numbing fight-or-flight neurochemicals—which can bring at least temporary relief to the bouts of fatiguing depression that often accompany trauma. And there are also unconscious attempts to return to the previous trauma to “get it right this time”—to do what we wish we could have done the first time, to master our trauma.

Seattle social worker Laura van Dernoot Lipsky points out that these unconscious attempts to master our traumas often backfire and simply reinforce our old traumas. She says that many of us in health care and other helping professions are often using our work as a form of trauma mastery, and that by doing so, we may set expectations for ourselves and others that are “untenable and destructive.” (1) She advocates ongoing efforts aimed at self-discovery and self-empathy, and points to the many positive examples of “people who have been effective in repairing the world while still in the process of repairing their own hearts.” (2) Eve Ensler, with the combination of personal work and “world repair” work that she describes in her powerful book In the Body of the World, is one of my favorite examples of this sort of balanced approach. (3)

 

Sources:

1 and 2, Laura van Dernoot Lipsky with Connie Burk, Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others (San Francisco: Berrett-Koehler Publishers, 2009), page 159.

3, Eve Ensler, In the Body of the World (New York: Metropolitan Books, 2013).

 

Hell Hath No Fury

IMG_6292Hell hath no fury like a host of women “getting woke” and speaking truth to misogynistic power—including that of our current U.S. President who, of course, is on record scorning and belittling women and treating them as sexual objects and then attempting to place gag orders on them.

Hell hath no fury like a host of women (and enlightened men) “getting woke” to the true meaning of being a feminist. Being a feminist goes beyond the wearing of pink pussy hats and marching (although I have done both of those things and they are an important start). Being a feminist goes beyond supporting the #MeToo movement and the brave women who are feeling empowered to speak up about sexual violence.

I am heartened by the increasing number of ethical and solid investigative news reports which bring to light and lead to due justice, not only the mind-bogglingly large cases such as the serial pedophile passing as sports physician Larry Nassar, but also the smaller yet life-altering stories of the many women (or women like them) who live next door—or who may be your daughter, sister, aunt, grandmother, or mother—or yourself. One recent, and local (to me) example of such a news story appeared in the Seattle Times this past week: “‘Shouting it from the rooftops’: Women confront abuse—even decades later” by Susan Kelleher (March 23, 2018). While this news report focuses on women’s stories of sexual harassment and abuse in the workplace, and therefore excludes such abuse in women’s homes and personal lives (where the vast majority of gender-based violence occurs), it is an illuminating and compassionate series of stories. As a woman and a nurse, I especially resonate with the story of retired nurse, Virginia Dawson. Dawson recounts the sexual harassment she endured early in her career at the pawing hands of a hospital physician. He even attempted to kidnap and sexually assault her in the morgue elevator. Female nurses continue to be targets of sexual harassment and abuse in the workplace by patients, family members, and co-workers.

There are, and will continue to be, nasty backlash and negative repercussions for women who speak their truth. I applaud the many good people across our country who are donating their legal, mental health counseling, and other support services to the many thousands of women who do not have the resources of the high-profile likes of Stormy Daniels (Stephanie Clifford in real life).

Hell hath no fury like a host of women “getting woke,” speaking up, joining and supporting the #MeToo movement, learning the true meaning of being a feminist, registering and voting their consciences in the next elections—or who even run for political offices themselves. #MeToo becomes #PowerToThePolls.  Don’t just get angry. Do something constructive with the power of that anger: Vote. And help other people around you to vote for candidates who have the guts to stand up for safer gun regulations, reproductive rights for women, effective anti-violence programs, healthcare programs that work—and who have proven track records of deep respect for all living beings, including women.

Prostitution: The Oldest Oppression

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Gloria Steinem/Sponsored by Hedgebrook at Seattle’s Benaroya Hall, 11-8-15. Photo credit: Josephine Ensign/2015

Gloria Steinem reminds us that prostitution is not the oldest profession for women, but rather it is the oldest oppression of women. This is not just some catchy, smart play on words by a feminist icon. It contains powerful truths. It contains powerful truths that affect public health and policy. It contains powerful truths that affect all of us, even if we prefer to think that it doesn’t.

I’m writing this post the morning after TV actor Charlie Sheen publicly announced he is HIV positive, and linked his infection to his history of alcohol/drug use combined with his ‘use’ of prostitutes. (See NYT article “Charlie Sheen says he has HIV and has paid millions to keep it secret,” by Emily Steel, 11-17-15.) Considering the fact that ‘use’ of female prostitutes by heterosexual men is correlated with high scores for men on different masculine hostility measures, it strikes me as ironic that Sheen’s last–and now cancelled– TV series was titled Anger Management.

Hopefully, most people know that prostitution is not the twisted Cinderella Hollywood version Julia Roberts portrays in the movie Pretty Woman. But Pretty Woman was written and directed by two fairly macho men, and it was released in the dark ages of 1990. Surely the portrayal of prostitution is much improved today. But no. Even the women’s rights advocate, TV screenwriter and producer Shonda Rhimes, is woefully disappointing on this issue. I recently watched the first season of Scandal (which Rhimes wrote and produced) in which the main character–the professional ‘fixer’ played admirably by Kerry Washington–puts on her white hat/gladiator woman power suit and successfully defends a Washington, DC high-class escort/prostitution madame, allowing her to retire as a rich grandmother in Boca Raton, Florida.

In my thirty-plus years work as a nurse, I have worked with many young women involved in prostitution. I was always clear that it was sexual exploitation for underage girls, but within the progressive subculture of clinics/agencies I worked in, we called adult prostitution ‘sex work,’ and erred on the side of harm reduction: trying to help minimize the harms of prostitution to the patient and the public. In many ways–as I view it now–we were supporting their lifestyle, enabling it, and becoming part of the problem. I remain a strong advocate of harm reduction, especially as it pertains to drug/alcohol addiction, but not applied to prostitution.

I know prostitutes who call it a profession, who say they freely choose their work. I’d like to believe them because it would make my work easier. But so many prostitutes (female, male, transgender) have histories of previous sexual abuse as children. Their bodies are not their own; their bodies have been stolen from them. In such situations free choice is not possible. This, combined with the growing evidence that prostitution–even in countries where it is legal and regulated (including health screens/care)–is one of the most hazardous ‘jobs’ in the world, has led me to the conclusion that prostitution is the oldest form of oppression. Prostitution is part of violence against women.

So, what to do about it? In my hometown of Seattle, we have begun to adopt the ‘Nordic Model’ of intervention: decriminalizing (and diverting to supportive care, including housing, health care, counseling, job training) prostitution for the women/transgender people involved, and stepping up criminalization efforts directed towards the customers–or ‘Johns’–and the pimps/BackPages/brokers in whatever forms they take. And along with stepping up legal ramifications for the buyers and the brokers, Seattle has innovative programs, such as OPS: The Organization for Prostitution Survivors. OPS has a drop-in center for women, survivor support groups, art workshops for survivors, as well as community-based service provider trainings, and the new Stopping Sexual Exploitation: A Program for Men (SSE).

Last week I visited OPS and talked with OPS co-founder (with survivor/activist Noel Gomez) Peter Qualliotine. Peter has taken the lead in designing and facilitating the SSE workshops. He explained that the SSE program was designed and piloted for two years and then began full operation in January 2015. He receives self-referrals as well as court referrals, and he’s hoping to be able to move it more heavily towards referrals. As he put it “8,000 men a day in King County are customers on BackPage,” so waiting for men to be ‘caught’ by either their wives/partners or the police and referred in to a ‘John’s School’ such as SSE, will not be very effective.

The SSE consists of a telephone intake conversation that Peter has with the men. He uses a motivational interviewing technique and asks the men, “How has this been a challenging time for you?” He said that with the rare exception of a man with psychopathic tendencies (my term here), the vast majority of men soliciting sex feel at least some qualms about it and also suffer negative consequences (sexually transmitted infections, guilt, relationship/legal/money issues).

The SSE program is based on the social-ecological model of violence prevention, and includes information and role-play on gender socialization and manhood training. It’s a support group model of three hour sessions over eight weeks, and is purposefully limited to ten men at a time. So far this year they have had sixty men complete the program, with some of the men so positively affected/changed by it that they have volunteered to help with further advocacy. (Stay tuned, because local and national news coverage on SSE is coming soon.)

Meanwhile, I know many people who work within public health realms in Seattle/King County who continue to advocate for legalizing prostitution, as if it is similar to ‘legalizing’ marijuana. And the otherwise admirable social justice/human rights organization, Amnesty International, is also advocating this stance–although they cleverly call it “protecting the human rights of sex workers.”