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Childhood trauma

How Childhood Trauma Could Be Mistaken for ADHD, via The Atlantic:

Dr. Nicole Brown’s quest to understand her misbehaving pediatric patients began with a hunch.

Brown was completing her residency at Johns Hopkins Hospital in Baltimore, when she realized that many of her low-income patients had been diagnosed with attention deficit/hyperactivity disorder (ADHD).

These children lived in households and neighborhoods where violence and relentless stress prevailed. Their parents found them hard to manage and teachers described them as disruptive or inattentive. Brown knew these behaviors as classic symptoms of ADHD, a brain disorder characterized by impulsivity, hyperactivity, and an inability to focus.

When Brown looked closely, though, she saw something else: trauma. Hyper-vigilance and dissociation, for example, could be mistaken for inattention. Impulsivity might be brought on by a stress response in overdrive.

“Despite our best efforts in referring them to behavioral therapy and starting them on stimulants, it was hard to get the symptoms under control,” she said of treating her patients according to guidelines for ADHD. “I began hypothesizing that perhaps a lot of what we were seeing was more externalizing behavior as a result of family dysfunction or other traumatic experience.”

Inattentive, hyperactive, and impulsive behavior may mirror the effects of adversity, and many doctors don’t know how—or don’t have time—to tell the difference.

Considered a heritable brain disorder, one in nine U.S. children—or 6.4 million youth—currently have a diagnosis of ADHD. In recent years, parents and experts have questioned whether the growing prevalence of ADHD has to do with hasty medical evaluations, a flood of advertising for ADHD drugs, and increased pressure on teachers to cultivate high-performing students. Now Brown and other researchers are drawing attention to a compelling possibility: Inattentive, hyperactive, and impulsive behavior may in fact mirror the effects of adversity, and many pediatricians, psychiatrists, and psychologists don’t know how—or don’t have the time—to tell the difference.

Though ADHD has been aggressively studied, few researchers have explored the overlap between its symptoms and the effects of chronic stress or experiencing trauma like maltreatment, abuse and violence. To test her hypothesis beyond Baltimore, Brown analyzed the results of a national survey about the health and well-being of more than 65,000 children.

Brown’s findings, which she presented in May at an annual meeting of the Pediatric Academic Societies, revealed that children diagnosed with ADHD also experienced markedly higher levels of poverty, divorce, violence, and family substance abuse. Those who endured four or more adverse childhood events were three times more likely to use ADHD medication.

Interpreting these results is tricky. All of the children may have been correctly diagnosed with ADHD, though that is unlikely. Some researchers argue that the difficulty of parenting a child with behavioral issues might lead to economic hardshipdivorce, and even physical abuse. This is particularly true for parents who themselves have ADHD, similar impulsive behavior or their own history of childhood maltreatment. There is also no convincing evidence that trauma or chronic stress lead to the development of ADHD.

For Brown, who is now a pediatrician at Montefiore Medical Center in the Bronx, the data are cautionary. It’s not evident how trauma influences ADHD diagnosis and management, but it’s clear that some misbehaving children might be experiencing harm that no stimulant can fix. These children may also legitimately have ADHD, but unless prior or ongoing emotional damage is treated, it may be difficult to see dramatic improvement in the child’s behavior.

“We need to think more carefully about screening for trauma and designing a more trauma-informed treatment plan,” Brown says.

Dr. Kate Szymanski came to the same conclusion a few years ago. An associate professor at Adelphi University’s Derner Institute and an expert in trauma, Szymanski analyzed data from a children’s psychiatric hospital in New York. A majority of the 63 patients in her sample had been physically abused and lived in foster homes. On average, they reported three traumas in their short lives. Yet, only eight percent of the children had received a diagnosis of post-traumatic stress disorder while a third had ADHD.

“I was struck by the confusion or over-eagerness–or both–to take one diagnosis over another,” Szymanski says. “To get a picture of trauma from a child is much harder than looking at behavior like impulsivity, hyperactivity. And if they cluster in a certain way, then it’s easy to go to a conclusion that it’s ADHD.”

A previous edition of the Diagnostic and Statistical Manual of Mental Disorders urged clinicians to distinguish between ADHD symptoms and difficulty with goal-directed behavior in children from “inadequate, disorganized or chaotic environments,” but that caveat does not appear in the latest version. Unearthing details about a child’s home life can also be challenging, Szymanski says.

It’s not clear how many children are misdiagnosed with ADHD annually, but the number could be nearly 1 million.

A child may withhold abuse or neglect to protect his family or, having normalized that experience, never mention it all. Clinicians may also underestimate the prevalence of adversity. The Adverse Childhood Experiences Study, a years-long survey of more than 17,000 adults, found that two-thirds of participants reported at least one of 10 types of abuse, neglect, or household dysfunction. Twelve percent reported four or more. That list isn’t exhaustive, either. The study didn’t include homelessness and foster care placement, for example, and the DSM doesn’t easily classify those events as “traumatic.”

It’s not clear how many children are misdiagnosed with ADHD annually, but a study published in 2010 estimated the number could be nearly 1 million. That research compared the diagnosis rate amongst 12,000 of the youngest and oldest children in a kindergarten sample and found that the less mature students were 60 percent more likely to receive an ADHD diagnosis.

Though ADHD is thought to be a genetic condition, or perhaps associated with lead or prenatal alcohol and cigarette exposure, there is no brain scan or DNA test that can give a definitive diagnosis. Instead, clinicians are supposed to follow exhaustive guidelines set forth by professional organizations, using personal and reported observations of a child’s behavior to make a diagnosis. Yet, under financial pressure to keep appointments brief and billable, pediatricians and therapists aren’t always thorough.

“In our 15-minute visits—maybe 30 minutes at the most—we don’t really have the time to go deeper,” Brown says. If she suspects ADHD or a psychological condition, Brown will refer her patient to a mental health professional for a comprehensive evaluation. “You may have had this social history that you took in the beginning, but unless the parent opens up and shares more about what’s going on in the home, we often don’t have the opportunity or think to connect the two.”

Caelan Kuban, a psychologist and director of the Michigan-based National Institute for Trauma and Loss in Children, knows the perils of this gap well. Four years ago she began offering a course designed to teach educators, social service workers and other professionals how to distinguish the signs of trauma from those of ADHD.

“It’s very overwhelming, very frustrating,” she says. “When I train, the first thing I tell people is you may walk away being more confused than you are right now.”

In the daylong seminar, Kuban describes how traumatized children often find it difficult to control their behavior and rapidly shift from one mood to the next. They might drift into a dissociative state while reliving a horrifying memory or lose focus while anticipating the next violation of their safety. To a well-meaning teacher or clinician, this distracted and sometimes disruptive behavior can look a lot like ADHD.

Kuban urges students in her course to abandon the persona of the “all-knowing clinician” and instead adopt the perspective of the “really curious practitioner.”

Rather than ask what is wrong with a child, Kuban suggests inquiring about what happened in his or her life, probing for life-altering events.

Jean West, a social worker employed by the school district in Joseph, Missouri, took Kuban’s course a few years ago. She noticed that pregnant teen mothers and homeless students participating in district programs were frequently diagnosed with ADHD. This isn’t entirely unexpected: Studies have shown that ADHD can be more prevalent among low-income youth, and that children and adolescents with the disorder are more prone to high-risk behavior. Yet, West felt the students’ experiences might also explain conduct easily mistaken for ADHD.

Kuban’s course convinced West to first consider the role of trauma in a student’s life. “What has been the impact? What kind of family and societal support have they had?” West asks. “If we can work on that level and truly know their story, there’s so much power in that.”

As a school official, West sometimes refers troubled students to a pediatrician or psychiatrist for diagnosis, and meets with parents to describe how and why adversity might shape their child’s behavior. In her private practice, West regularly assesses patients for post-traumatic stress disorder instead of, or in addition to, ADHD.

Though stimulant medications help ADHD patients by increasing levels of neurotransmitters in the brain associated with pleasure, movement, and attention, some clinicians worry about how they affect a child with PTSD, or a similar anxiety disorder, who already feels hyper-vigilant or agitated. The available behavioral therapies for ADHD focus on time management and organizational skills, and aren’t designed to treat emotional and psychological turmoil.

Instead, West teaches a traumatized child how to cope with and defuse fear and anxiety. She also recommends training and therapy for parents who may be contributing to or compounding their child’s unhealthy behavior. Such programs can help parents reduce their use of harsh or abusive discipline while improving trust and communication, and have been shown to decrease disruptive child behavior.

Szymanski uses a similar approach with patients and their parents. “I think any traumatized child needs individual therapy but also family therapy,” she says. “Trauma is a family experience; it never occurs in a vacuum.”

Yet finding a provider who is familiar with such therapy can be difficult for pediatricians and psychiatrists, Szymanski says. Though some hospitals have centers for childhood trauma, there isn’t a well-defined referral network. Even then, insurance companies, including the federal Medicaid program, may not always pay for the group sessions commonly used in parent training programs.

Faced with such complicated choices, Szymanski says it’s no surprise when clinicians overlook the role of trauma in a child’s behavior and focus on ADHD instead.

Inattentive and hyperactive behavior can be traced back to any number of conditions—just like chest pains don’t have the same origin in every patient.

While there are few recommendations now for clinicians, that will likely change in the coming years. The American Academy of Pediatrics is currently developing new guidance on ADHD that will include a section on assessing trauma in patients, though it won’t be completed until 2016.

Dr. Heather Forkey, a pediatrician at University of Massachusetts Memorial Medical Center, who specializes in treating foster children, is assisting the AAP. Her goal is to remind doctors that inattentive and hyperactive behavior can be traced back to any number of conditions—just like chest pains don’t have the same origin in every patient. Ideally, the AAP will offer pediatricians recommendations for screening tools that efficiently gauge adversity in a child’s life. That practice, she says, should come before any diagnosis of ADHD.

When speaking to traumatized children inappropriately diagnosed with ADHD, she offers them a reassuring explanation of their behavior. The body’s stress system, she says, developed long ago in response to life-or-death threats like a predatory tiger. The part of the brain that controls impulses, for example, shuts off so that survival instincts can prevail.

“What does that look like when you put that kid in a classroom?” Forkey asks. “When people don’t understand there’s been a tiger in your life, it looks a lot like ADHD to them.”


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Supporting teen survivors

7 ways to help a teen survivor of sexual assault, via Everyday Feminism:

(Trigger Warning)

It is devastating to discover that a teen you love has been a victim of sexual violence. When faced with their pain and confusion, you may find yourself feeling powerless to help. If the victim is your own child, the sense of grief can be consuming.

Remember, you are not alone. Other parents and allies have walked this healing path and can help guide you and your loved one through recovery.

As the Founder and Director of Survivor Healing and Empowerment, a healing community for survivors of rape, abuse and domestic minor sex-trafficking, I want you to know that there are many ways you can compassionately support the teen survivor in your life.  44% of sexual assault victims are under the age of 18, so we need to carefully assess the unique needs of young men and women who have endured this trauma. Some of the resources I share will be more applicable to teen girls, but many of these suggestions serve survivors of all gender identities.

Here are are 7 tips to help begin this journey to wholeness:

1. Encourage your loved one to express herself. Victims of sexual assault are three times more likely to suffer from depression. Psychologist Dana C. Jack calls depression “the silencing of the self.” Consider finding a counselor who integrates expressive arts therapies (such as art, music or dance therapy). Creative expression helps teens connect with and process the truth of their experience. Writing as A Way of Healing by Louise A. DeSalvo and The Artist’s Way by Julia Cameron are excellent sources of encouragement for a survivor who wants to heal through creative expression.

2. Help her explore contemplative practices. A contemplative practice quiets the mind in order to cultivate a personal capacity for deep concentration and insight. Examples include yoga, tai chi, meditation and prayer. This is particularly helpful in healing dissociation, a way that trauma victims disconnect from their experience in order to survive. If your loved one has been abused by a religious figure or someone affiliated with your spiritual community, don’t push religion as a source of healing. Give her space to discover their own spiritual path.

3. Visit the website for Rape, Abuse, Incest National Network. Through this site you can search for your local rape crisis center and learn more about sexual assault. Direct your teen to the Online Hotline, an instant messaging section where she will be connected with a trained advocate who will answer any of her questions. After connecting with your local crisis center, research recovery groups and ask for referrals. She needs to know that she is not alone. Hearing the stories of other survivors helps to heal self-blame and shame. I also highly recommend Invisible Girls: The Truth About Sexual Abuse by Dr. Patti Feuereisen as a recovery companion.

4. Engage her in discussions about the media. Help her dismantle messages that reinforce sexual objectification. Verbal abuse expert, Patricia Evans, says that verbal abuse occurs when someone “tells lies about who you are.” Mainstream media constantly tells lies about who girls are. Make sure that she can critically engage with representations of girls and women that emphasize their value as sexual commodities. For excellent feminist critiques of pop culture in a teen-friendly space, check out Bitch Magazine. SPARK is an innovative organization helping girls differentiate between sexuality and sexualization.

5. Talk about healthy relationships. Surviving sexual assault is one of greatest predictors for your teen to eventually experience some form of relationship violence. Be pro-active in discussing the difference between an abusive and a respectful relationship. Model this in your own life and refer her to as well as the sex-positive teen site

6. Honor her boundaries. Ask for permission before touching or hugging the survivor. It is important that she feel in control of her body at all times. You can discuss safety planning, but make sure that you do not take away her freedoms out of your own fear. Check out the Circle of 6, a cutting-edge app that will help her stay safe.

7. Never blame the survivor. Remind her that it is not her fault. She did whatever she needed to in order to survive. Ultimately, the greatest gift you can give is to be a patient, empathetic listener. To learn the basics of empathetic listening, read a book such as Non-Violent Communication by Marshall Rosenberg, PhD.

Be gentle with yourself and your teen during this time of recovery. Self-care is essential for both of you. Do not hesitate to reach out to a counselor or rape crisis center for support as you process what has happened. Sexual assault is devastating, but there is hope for those who choose a healing path.

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Male victims and rape culture

6 Ways Jokes About Violence Against Men Harms Male Victims, via Good Men Project:

hand over mouth andy rennie resized 4429438847_b4a3a72491_z

There’s a meme going around these days about a man who buys his wife a mood ring so he’ll know how she’s feeling. When she’s in a good mood, it turns green. When she’s in a bad mood, it leaves a big red mark on his forehead. That’s got to be the most literal punch-line I’ve ever seen.

Maybe you find that funny.

Perhaps you caught Bill Maher’s commentary on a recent study revealing that boys and men are sexually abused at much higher rates than Americans expected. He joked that they weren’t abused, they just “got lucky” and mocked them for not understanding that.

Maybe you find that funny.

You’ve surely heard jokes about male prisoners who smell bad because when they drop the soap in the shower, they can’t bend down to pick it up.

Maybe you find that funny.

Although it’s fiction, Any Dufresne (Tim Robbins In The Shawshank Redemption) may well be the only guy you know who’s been in prison. You probably didn’t find his attempted rape funny.

Many people were shocked when we learned about priests molesting and raping boys. I don’t know anyone who thought that was funny.

When Ivan Lopez opened fire at Fort Hood a few weeks ago, he killed three men: Sergeant First Class Daniel Ferguson, Staff Sergeant Carlos Lazeney-Rodriguez, and Sergeant Timothy Owens. I’m guessing you don’t think that’s funny at all.

The moral of our story seems to be that it’s funny when men are the victims of violence, as long as the victim isn’t innocent and no one gets killed.

I’m sure a meme that joked about a woman ending up with a welt on her forehead from her husband’s ring would be reported as offensive. I know a comedian who joked about a woman getting raped would be damned all over the Internet; just ask Tosh. Violence against women isn’t funny, but violence against men is hilarious. WTH?

When we publicly laugh at male victims of violence, we’re mocking them for being victims. That sends a pretty clear message, and one that’s a central pillar of the manbox: Don’t be a victim.

Rapper Chris Brown got the message. In an October interview, he revealed that he lost his virginity at age 8 to a girl he thinks was 14 or 15. He talked about this as a conquest and took it as evidence of his sexual prowess—he was irresistible at age 8. I suppose Maher would agree. But many writers called it rape and rightly pointed out the double standard: no one would dare suggest that an 8 year old girl who had sex with a 14 or 15 year old boy got lucky; they’d call it rape.

The double standards and the jokes hide male violence from view and are part of the reason that the US doesn’t really deal with male victims on a national level. You’ve probably never seen these stats:

  • Men and boys make up approximately 75% of the victims of homicide, triple the rate of women and girls, a ratio that has remained fairly constant since 1980 according to the federal Bureau of Justice Statistics.
  • The 2010 National Intimate Partner and Sexual Violence Survey revealed that approximately 6% of men—one in 20—has either been raped or forced to penetrate someone else. Christopher Anderson, executive director of Male Survivor, reports that when all forms of sexual violence are combined, the rate is almost 25% of men. (see comments.) The rate of 1 in 6 men is also commonly reported.
  • The National Coalition Against Domestic Violence (NCADV) estimates that 835,000 men are physically assaulted by an intimate partner every year. Assaults are committed by gay and straight men, known intimates and strangers.
  • In the US Military, men “are an estimated 53% of victims, and yet nobody seems to be paying attention to them,” according to Chris Kilmartin, Distinguished Visiting Professor of Behavioral Science and Leadership at the United States Air Force Academy. Kilmartin notes that the chance of any given man in the military being sexually assaulted is lower than for any given woman, but since men make up more than 85% of the military, the total number of male victims is higher.
  • In the study that Maher mocked, Bryana French and her colleagues surveyed nearly 300 high school and college males. More than 40% had been pressured to engage in sex they didn’t want to have; half of them, approximately one-fifth of all the guys who completed surveys, ended up having sex when they didn’t want to. Isn’t that the basic definition of rape: being compelled to have sex when you don’t want to?

So what? Why does it matter that we don’t take violence against boys and men seriously? A few reasons. And let me acknowledge up front that most of the individual effects aren’t unique to men.

  1. It reinforces our cultural notion that any male should be able to protect himself against any attacker. At this level, it tells us that any male victim is at least partly responsible for what happened. This same logic that says a woman who wears a short skirt is partly responsible for being raped. And if you’re partly responsible for your own victimization, then you don’t really deserve our sympathy or help.
  2. Despite the numbers, we don’t really devote national resources to solving the problems. All of the attention to sexual assault in the military has been about female victims. Discussions of male-on-male homicide only gets systematic attention as “black on black” or “inner city” violence, limiting the problem to a particular ethnic group or geographical setting. Yet boys and men of all ethnic groups and in all locations are homicide victims.
  3. Humor is one way we relieve stress. By telling jokes about male victims, we don’t have to deal with something that might be difficult, we can just relieve our anxiety and move on without thought.
  4. For individual male victims, it reinforces the notion that any male victim is less of a man because he couldn’t defend himself. Many victims are ashamed at having done something stupid that may have contributed to their victimization, but it’s often compounded for guys because they’re ashamed that they were unable to defend themselves.
  5. For male victims, this all makes it harder to admit they’re victims and get help. That means much less support from friends and family members. It may also mean a shorter lifespan, as Will Courtenay argues in Dying to Be Men.
  6. For male victims, the unhealed trauma often leads to decreased empathy for others. That’s one piece of the puzzle that’s common among school shooters, family mass murders (or “domestic terrorism” or “household terrorism”), and other acts of mass violence.

When you make a joke or laugh about male victims, you send a message to victims that you’re not entirely trustworthy. You are literally laughing at their pain. So next time you’re contemplating making fun of male victims, or laughing when someone else makes fun of them, ask yourself if that’s really the message you want to send. Maybe it’s not funny after all.

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Affirmative Consent

What ‘Affirmative Consent’ Actually Means, via Think Progress:

Penn State students spreading the word about consent

proposed bill in California that would require college students to obtain explicit consent before proceeding with a sexual encounter is sparking controversy over whether that standard can actually work in practice. The legislation, which was introduced as a direct response to the current sexual assault crisis on college campuses, defines consent as an “affirmative, conscious, and voluntary agreement to engage in sexual activity” every step of the way. There are some concerns that’s much too broad.

“I feel like their hearts are in the right place, but the implementation is a little too excessive,” a biology major at Cal State Long Beach told the Long Beach Press Telegram. “Are there guidelines? Are we supposed to check every five minutes?”

“Whether anyone could feel ‘sexy’ under such conditions seems dubious at best,” concurs arecent piece published in the libertarian magazine Reason that also calls California’s proposal both “absurd” and “dangerous.”

And in a Washington Post article entitled “YOU are a rapist; yes YOU,” law professor David Bernstein argues that requiring a standard of explicit consent for sexual encounters “makes almost every adult in the U.S. (men AND women) — and that likely includes you, dear reader — a perpetrator of sexual assault.” Bernstein is mainly concerned about the ambiguous first steps of initiating a sexual encounter, giving the example of a woman who may unbutton a man’s shirt without explicitly asking.

There are legitimate questions about whether state legislation is the right vehicle for instilling a culture of affirmative consent on college campuses. But much of the hyperbolic concern over turning students into rapists and taking the fun out of sex stems from a misunderstanding about how affirmative consent actually operates in practice.

Affirmative consent isn’t based on the idea that every sexual encounter is a rigid contract between two parties. No one is suggesting that college students need to run through a checklist before unbuttoning each other’s shirts. Instead, it’s more about broadly reorientingabout how we approach sex in the first place.

The current societal script on sex assumes that passivity and silence — essentially, the “lack of a no” — means it’s okay to proceed. That’s on top of the fact that male sexuality has been socially defined as aggressive, something that can result in men feeling entitled to sex, while women have been taught that sex is something that simply happens to them rather than something they’re an active participant in. It’s not hard to imagine how couples end up in ambiguous situations where one partner is not exactly comfortable with going forward, but also not exactly comfortable saying no.

Under an affirmative consent standard, on the other hand, both partners are required to pay more attention to whether they’re feeling enthusiastic about the sexual experience they’re having. There aren’t any assumptions about where the sexual encounter is going or whether both people are already on the same page. At its very basic level, this is the opposite of killing the mood — it’s about making sure the person with whom you’re about to have sex isexcited about having sex with you.

Making sure someone else is enthusiastic about what you’re doing with them requires you to consider their wants and needs, think about how to bring them pleasure, and ultimately approach sex like a partnership instead of a means to your own end.

It’s admittedly somewhat of a departure from the way our society often approaches sex; recent studies have found that most college students feel uncomfortable voicing their desires during sexual encounters, and there’s a gender imbalance in whose pleasure is prioritized. But the emphasis on getting consent isn’t an effort to turn everyone into rapists. It’s just about encouraging better communication across the board.

“Consent isn’t a question. It’s a state,” feminist writer Jaclyn Friedman, who wrote a book on enthusiastic consent, explained in a blog post back in 2010. “If, instead of lovers, the two of you were synchronized swimmers, consent would be the water. It’s not enough to jump in, get wet and climb out — if you want to swim, you have to be in the water continually. And if you want to have sex, you have to be continually in a state of enthusiastic consent with your partner.”

The people who are worried about affirmative consent standards are typically preoccupied about the people who may be penalized for failing to ask questions every step of the way. What if a college student starts passionately kissing his girlfriend without getting her permission first? What if a couple enjoys explicitly consensual foreplay and then moves on to intercourse without a verbal agreement beforehand?

But those hypothetical situations aren’t necessarily breaches of an affirmative consent standard. If both partners were enthusiastic about the sexual encounter, there will be no reason for anyone to report a rape later. So if college students are worried about protecting themselves from being penalized, it’s not hard — all they have to do is stick to engaging in physical contact with people who are clearly receptive to it at the time. That doesn’t include girls who are passed out drunk, but it probably does include most couples in long term relationships, who are used to communicating their needs to each other. There are certainly some gray areas in sexual encounters, and it’s sexually active young adults’ responsibility to figure out how to navigate them effectively.

That’s likely not enough to pacify the critics who are concerned about women abusing the system and lying about rape in order to ruin men’s lives. But that’s a bigger problem. The supposed threat of false rape claims continues to be trotted out to undermine efforts to enact sexual assault reform, often by so-called “men’s rights activists” who are worried that feminists are primarily interested in victimizing them. In reality, false rape allegations are very rare, comprising about two to eight percent of all reports for a crime that’s alreadyvastly under-reported.

More broadly, it’s perhaps important to remember that California’s proposed law isn’t that groundbreaking on the collegiate level. The National Center For Higher Education Risk Management, which advises higher education institutions about how to craft effective sexual assault policies, has been recommending this type of consent standard for more than a decade. It’s already in place at colleges in the University of California system, as well as atmost Ivy League schools. In the midst of increased attention to issues of rape on campus, some universities are in the process of refining their definitions of consent even further to make sure students are on the same page.

“The shift in this country away from defining sexual violence as force-based conduct has been championed by many colleges, and is now the law in a majority of states,” the National Center For Higher Education Risk Management noted in a 2001 guide for campuses. “Many state criminal codes are antiquated, at best. Colleges are on the cutting edge with so many issues, ideas, and research. Sexual misconduct should be no different, and is an area in which colleges really can and do lead the way.”

The shirts pictured in the photo above are made by an organization called Only With Consent. If you’re no longer afraid of affirmative consent, you can get your own here.

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Sexual Assault on Maine college campuses

Does UMaine hold students accountable for sexual assaults on campus? via Bangor Daily News:

A shot of the University of Maine logo in Orono in March 2014. |Gabor Degre

On Oct. 2, 2010, the University of Maine in Orono learned of potential sexual misconduct by a student on campus.

Through the school’s disciplinary process, the student was found responsible for violating the university’s stalking and relationship abuse policy, harassment, substantial disruption of activities, violating the alcohol policy, possession of alcohol by a minor, causing imminent physical harm, engaging in conduct that endangers others and significant interference with the normal residential life of others.

We don’t know what exactly the student did because the university enforces its conduct code in an administrative manner, not in a public court of law. The name of the offending student, which the university refers to as the “respondent,” is confidential.

But we know the university handed down the following sanctions: probation, residence hall relocation, a meeting with a licensed drug and alcohol counselor, a meeting with a dean and what was recorded as “other sanction,” which typically involves education-related discipline such as community service or writing a reflection paper.

In the last five years, there have been 62 reported cases involving sexual violence, harassment, stalking, hazing, intimidation or physical assault among students at the University of Maine. Of those cases, 47 students were found responsible for violations through the school’s hearing process, according to university records. In several cases, victims dropped the complaint; in other cases, respondents were found “not responsible” but still faced sanctions, such as no-contact orders.

In that time, one student was expelled and eight were suspended. The majority of punishments for the range of policy violations included probation, required meetings with school officials, no-contact orders and the completion of community or education-related projects.

Did those sanctions improve students’ safety? How should universities and colleges punish students who violate administrative policies but haven’t always been convicted in court?

“I think most universities have their own [guidelines for sanctions], and it really is dependent on the culture of that institution,” said David Fiacco, the director of UMaine’s Office of Community Standards, Rights and Responsibilities. “Ours fall in line with what are the generally accepted practices,” which are guided by the Association for Student Conduct Administration and the Council for the Advancement of Standards in Higher Education.

For S. Daniel Carter, director of the 32 National Campus Safety Initiative at the VTV Family Outreach Foundation in Virginia, the question is whether disciplinary proceedings at colleges contribute to a culture that rejects sexual violence. The problem is that colleges and students have little solid information about what works.

“More research on how colleges and universities handle sexual violence is essential, with the conduct process being a very important part of that. There is a significant dearth of information available,” Carter said. “I frequently get asked questions to which there is no answer because the data does not exist, because it has not been studied, because there have been barriers to gathering the information, because it has not been funded.”

Universities and college campuses are bound by law to investigate cases of sexual violence and harassment and punish those found to have violated the school’s policies. It’s a separate process from the criminal justice system — purposefully crafted to allow administrators to act quickly to protect students.Campus discipline

Universities have been investigating incidents and disciplining students for centuries. It’s similar to how employers act when their employees commit minor infractions or full-fledged crimes. A company is unlikely to wait months or years for a conviction in court to fire an employee charged with embezzlement, for instance.

“As an institution of higher learning or an employer or any other agency, you would want to hold your employees or your students or your association members accountable to a certain standard of conduct,” Fiacco said.

Colleges are required by the federal law Title IX to act immediately — and independent of police — to investigate incidents and protect students. They can take action, such as removing a student from a residence hall, before the disciplinary hearing process takes place.

“If a school knows or reasonably should know about student-on-student harassment that creates a hostile environment, Title IX requires the school to take immediate action to eliminate the harassment, prevent its recurrence, and address its effects,” the U.S. Department of Education’s Office for Civil Rights told schools in a 2011 letter.

When the University of Maine learns of a possible code violation, officials investigate to see whether the complaint has merit. A hearing may then be held in which a hearing officer or a committee decides, by a “preponderance of the evidence,” whether the student conduct code has been violated and, if so, what the punishment will be. Both sides have the right to appeal.

It’s up to the victim, not the school, to report a sexual assault to police, though the school informs the student of available support services and criminal justice options.

Some argue colleges have swung too far in the direction toward punishing students without hard proof, while others say colleges still have a long way to go to hold students accountable.

The truth is, it’s hard to know, given the limited public information and research on the subject, whether specific sanctions are effective — by reducing re-offenses, making students feel safer, teaching offending students important lessons and contributing to a campus culture that encourages students to come forward and have faith in the disciplinary process.

“What I think we sometimes see in responses to sexual violence, within an institution, is a natural instinct to protect the institution — be that in the situation of a church or a long-term care facility or a college or university,” said Elizabeth Ward Saxl, the executive director of the Maine Coalition Against Sexual Assault.

It’s important for schools to ensure student victims have access to advocates to help them navigate the complaint process, make sure no one discourages students from going to police and make certain all people determining the outcome of sexual violence cases on campus have a significant amount of training on the dynamics of sexual assault, she said.

At the University of Maine, the most common sanction handed down to students found responsible for a range of infractions that include stalking, harassment, sexual abuse, or physical intimidation or assault, between July 1, 2009, and June 30, 2014, was probation, with a total of 38 instances. Each case resulted in students being found responsible for a number of infractions, and it’s not possible to break out the type of sanction handed down for each individual violation, as would be possible in a court finding. Sanctions are crafted based on the circumstances of each individual case.

Probation effectively puts the student and college on notice. If the student were to repeat the offense, he or she would likely receive a more severe punishment. For the purposes of this piece, “probation” encompasses disciplinary probation, deferred disciplinary suspension, deferred housing suspension and official warnings.

The second most common sanction during that time period was “loss of contact.” In a total of 22 instances, people found responsible for violating the campus code were prohibited from contacting the complainant or others involved.

The third most common sanction came in the form of educational or “alternative” punishments, in 21 instances. Sometimes the university refers to them as “other sanctions,” which could involve doing research projects, writing reflection papers, completing community service or participating in the outdoors adventure program, Maine Bound. The university also often recommends counseling or requires an assessment with a credential professional.

Fiacco, with UMaine, said his first priority is ensuring the safety and welfare of students. But sometimes students can benefit from more educational activities, to “redirect the students’ energies” and introduce them to different social networks. Instead of going out to drink, students might go rock climbing, he said, to “force them out of their comfort zone, to meet with other students doing other activities.”

In a case reported to the university in September 2013, a student was found responsible for possession of alcohol by a minor, violating the residence hall contract and discriminatory harassment, which is harassment or discrimination based on race, religion, sexual orientation, gender identity, national origin, age or disability. The student was found not responsible for sexual harassment. The punishments were deferred disciplinary suspension, which is a type of probation, 10 hours of community service and participation in the Maine Bound program.

Laura Dunn is a survivor of campus sexual assault and serves as the executive director and founder of SurvJustice, a national advocacy organization. Dunn said schools should be careful not to reinforce unhealthy misconceptions — such as the idea that counseling or writing reflective essays will help rehabilitate offenders — and no one should consider an outdoor adventure program a punishment.

Writing an essay or being told to participate in what could be a fun activity are not appropriate punishments, especially when students are found responsible for acts that could qualify as crimes in a legal setting. Why? “You haven’t addressed the hostile environment at all,” she said.

“No student should be able to ‘learn’ from violating another student’s body,” she said. “You don’t deserve to be on campus with that survivor.”

“The colleges that do it right are expelling or suspending.”

The broader question

Carter, with the VTV Family Outreach Foundation, said the broader question is whether sanctions at universities contribute to students’ feeling of safety and faith in the campus judicial process. There are many barriers to reporting sexual assault: fear of retribution, fear anonymity will not be preserved, and social pressures, among others. The conduct hearing process is often another.

“Lack of effective justice can be a major barrier to victims and survivors pursuing an investigation if they know through what they’ve heard in the community that people found responsible for committing a sexual assault, for example, receive a deferred suspension, not an actual suspension or expulsion. They may elect not to pursue based on that because they may feel that a no-contact directive is not sufficient,” he said.

According to UMaine’s records, most students reporting sexual assault, sexual harassment and stalking in the spring and fall of 2013 did not pursue investigations, whether through the conduct hearing process or police. Of the 33 students who reported sexual assaults in that time, 23 did not pursue an investigation. Of the 32 students who reported sexual harassment, 21 did not pursue an investigation. And of the four stalking reports, three did not pursue an investigation.

When student complainants did come forward, about 44 percent of stalking, sexual violence, harassment, sexual harassment, hazing, and physical assault or threatening allegations resulted in the offending student being found responsible.

Several complainants did not want to provide the university with the name of the potential offender; several could have filed a police report without the university’s knowledge. But the numbers are consistent with what experts know about people who experience sexual violence or harassment: It’s hard to talk about, and the formal disciplinary or criminal process can be daunting.

And while it’s probably good that more students are coming forward at UMaine –mirroring a nationwide trend — there is less information about whether victims there, and at campuses across the country, are getting justice from the process.

The National Institute of Justice reviewed the sanctions handed down at colleges and universities across the country in 2005, but “a large gap remains in the research as to the effectiveness of such sanctions at preventing sexual assault victimization and perpetration among college students,” said Bonnie Fisher, a professor at the University of Cincinnati’s School of Criminal Justice and author of campus sex crimes studies. “Knowing about the effectiveness of these sanctions is a next logical step in preventing sexual assault among college students.”

To reach a sexual assault advocate, call the Statewide Sexual Assault Crisis and Support Line at 800-871-7741, TTY 888-458-5599. This free and confidential 24-hour service is accessible from anywhere in Maine. Calls are automatically routed to the closest sexual violence service provider.

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Romanticizing violence in pop culture

Robin Thicke’s video: further evidence that we’re romancing the stalker-esque, via The Guardian:

A woman drowning, a bloodied face, a man turning his fingers into a gun and pointing it at his own head: not exactly the stuff of romance! Yet this – along with a bunch of private text messages – is the imagery that makes up the music video for Get Her Back, the lead single from creepy crooner Robin Thicke on his followup to his number-one selling album Blurred Lines. And this is just one song on an entire record dedicated to winning back the affection of his estranged wife, the actress Paula Patton. Whatever happened to good old-fashioned chocolate and flowers?

Thicke’s new album, titled – what else? – Paula, features tracks called You’re My Fantasy, Still Madly Crazy, Something Bad, Whatever I Want and Lock the Door, among others. The disturbing video, released on Monday, features real SMS messages sent between Thicke and Patton, interspersed with images of violence, and ends ominously with a shadowy figure walking off into the distance with these words: This is just the beginning. So far, the video has been called “vulnerable” and“emotional”; album write-ups call Thicke “repentant” with this “romantic gesture”.

I think a more accurate term would be stalker-ish.

The US Department of Justice defines stalking as “a pattern of repeated and unwanted attention, harassment, contact … that would cause a reasonable person to feel fear.” That definition explicitly includes the repeated sending of unwanted presents and flowers, waiting for a woman at home or school, or making indirect threats. Does selling a music video with a look-a-like of your wife drowning count?

None of us know the ins and outs of the Patton and Thicke’s relationship outside of what’s public – they were high school sweethearts and they have a child together. But romanticizing the creepy and potentially harassing efforts of a man obsessed with this ex sends a dangerous message to young men about what “romance” really is. Hint: it has nothing to do with haranguing and publicly shaming us back into a relationship.

Thicke is hardly alone in his interpretation of what constitutes a grand romantic gesture. Stalking or behavior bordering on such is a huge part of the narrative around romance, especially in pop culture: the boy keeps trying to get the girl until she says yes. You need to look no further than the outrageously popular Twilight series – books and movies – to know that the stalker-as-romantic lead looms large in our cultural imagination. From There’s Something About Mary to Groundhog Day, the guy who would do anything to land the girl is supposedly the stuff women’s dreams are made of. (Of course, there’s no room for female protagonists or celebrities doing the same, like, say, Glenn Close in Fatal Attraction. She’d be called nuts in less time than it takes to get through the YouTube ad before a music video.)

It doesn’t surprise me that a man whose hit song sounded like an assault anthem and featured a video full of naked models would attempt to get back his wife via public pressure and a threatening music video. And the Get Her Back video is threatening. From the drowning to the finger gun (threatening suicide is a common signal of an abuser), the video sends a message that Thicke won’t take no for an answer. And that’s not romantic – it’s just downright scary.

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Title IX

“Red tape won’t cover up rape”: The silent protests that are sweeping college campuses, via Think Progress

Brown University students line up for graduation with red tape on their capsBrown University students line up for graduation with red tape on their caps

The academic year has wound to a close, but student activists aren’t slowing down. In order to keep attention on sexual assault policy reform — an issue that has recently captured national headlines and inspired White House action — graduating seniors at elite universities are using red tape to make a big statement.

Red tape isn’t a new symbol for sexual assault reform. But it’s made a comeback at several colleges this commencement season, where students are placing it on their mortarboards as a symbol of solidarity with rape survivors whose cases may have been mishandled by their administrators. Some students used the tape to spell out “IX” as a nod to the federal gender equity law Title IX, which requires colleges to maintain a safe environment for students by addressing sexual assault.

The visual tool first originated at Columbia University in 1999 and 2000, when the students there were attempting to pressure their administrators to update the school’s inadequate rape policy.

“Throughout that school year, hundreds of Columbia students started wearing red tape on their wrists, their backpacks, and any other items they’d carry with them frequently,” Tracey Vitchers, the communications coordinator for Students Active For Ending Rape (SAFER), a group that was first formed at Columbia, explained in an interview with ThinkProgress. “It was supposed to symbolize the bureaucracy of the old policy, to symbolize administrators really shutting students’ voices out of the reform process, and really call attention to the issue at hand — the college is putting all this red tape in front of students.”

Back then, “red tape won’t cover up rape” became somewhat of a rallying cry for student activists staging protests on campus.

This year, tensions over campus sexual assault came to a head once again. A group of 23 Columbia students filed a federal complaint against their school, accusing administrators of failing to address victims’ needs and doling out lenient punishments to rapists. Frustrated with administrators who didn’t appear to be doing enough to keep students safe, some activists started writing the names of accused rapists on bathroom stalls. An anti-rape group tried to protest at an event for prospective students and was quickly shut down.

According to Zoe Ridolfi-Starr, a junior at Columbia and one of the students who participated in filing the federal complaint this spring, current activists wanted to figure out how to keep putting meaningful pressure on the university officials. So they went back and looked at the way that sexual assault reforms had played out in previous years — and decided to bring back the red tape.

“We wanted to really claim that visual symbol and capture the contrast between our goal, which is the safety and well being of the whole student body, and the administration’s approach, which is more red tape,” Ridolfi-Starr told ThinkProgress. “Even now, they’re forming committees to review the committees, and they’re writing proposals on how to reform the committee to reform the committee, and nothing is changing for students. You haven’t fixed anything. It’s frustrating.”

red tape


Students started using red tape to hang up fliers with demands for administrators. They put up big red X’s in prominent places on campus. They taped over the mouth of the statue in front of the library. And then they put out a call for students to wear the tape on their graduation caps.

“By placing a piece of red tape on your cap (ideally parallel to the right side), you will demonstrate and signal to the University that you do not accept your degree lightly, that you understand the culture that they have been complicit in perpetuating, and that you will not stand for it, and that you demand justice and support for all survivors, even as a graduate of this institution,” student activists, who formed a direct action group called No Red Tape,wrote in an open letter to the campus last month.

Soon, activists at Brown, Harvard, and Dartmouth reached out to coordinate a media strategy for staging their own red tape protests. Hundreds of graduating seniors participated. Stanford University, which held its commencement this past Sunday, was the latest elite institution where seniors donned red tape. According to Miranda Mammen, one of the students who participated in the protest at Stanford, about 100 people put red tape on their caps and there was “a lot of student support even among those who didn’t wear red tape themselves.”

“People were really excited about it, and it was very cool to see that replicated at other campuses,” Ridolfi-Starr said. “I’m confident that red tape will continue to be a symbol.”

“We’re really excited to see that students are taking the steps at their graduation to have a silent protest,” Vitchers said, pointing out that the recent activism surrounding commencement ceremonies could signal some positive momentum for the sexual assault reform movement as a whole. “I think we’ll start to see some of these students who are graduating starting to engage more as alumni in this process, which we’re looking forward to seeing. Alumni can be really powerful in helping to support student advocacy on campus.”

“Even as graduates of this institution, everyone has a responsibility to continue to fight for a safe Columbia,” Ridolfi-Starr agreed. “Graduation is an important day for people, and I think some felt like this day is sacred and should be free from protest. But I actually think that it becomes even more important on special days, and on ceremonious days, to continue to fight for what we know to be right. It’s important that we do it even when it’s hard.”

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Two things you can do to prevent child abuse, via Bangor Daily News:

Last week, I attended the National Children’s Alliance Leadership Conference in Washington, D.C. During several interesting sessions about child sexual abuse and conversations with colleagues from around the country, I again was thinking about how to respond to the inevitable question of, “But what can I do to help prevent and respond to child sexual abuse?”

When people learn that I work for the Maine Coalition Against Sexual Assault, they generally ask two questions: “Does sexual violence really happen in Maine?” and “What can I do to help?” Especially when there are children or older adults involved, people tend to pay a particular amount of attention.

The first question is easy to answer: Yes, sexual violence happens in Maine. About 1 in 5 Mainers will experience rape or attempted rape at some point in their lifetime. It’s easy to talk about numbers because people are comfortable with numbers.

People, however, are less comfortable with behavior change, which makes the second question more difficult to answer. It involves examining our own behavior, acknowledging our own discomforts, and knowing when to ask for help. A few thoughts I had during the conference and conversations with various colleagues:

Recognizing a child’s body is her/his own. When I say this to people, their immediate reaction is, “Of course my kid’s body is his/her own!” Sometimes, though, in an effort to make auntie so-and-so feel included, we say things like, “Give Aunt Cara a hug and a kiss goodbye!” What if Sally doesn’t want to give Aunt Cara a hug and a kiss goodbye? This doesn’t seem like a big deal, but what this inevitably says to Sally is, “You have to hug or kiss someone even if you don’t want to because a grownup said so.”

Now, if Sally happens to be spunkier than the average kid, she may flat out deny the hug/kiss request and go on playing with her Legos. However, some kids may not feel so spunky. Saying to Sally, “If you don’t want to hug Aunt Cara, that’s OK, but let’s say goodbye,” helps to teach her manners but doesn’t put her in a position of having to hug or kiss someone she doesn’t want to hug or kiss. It helps children like Sally recognize and respect boundaries – their own and others. We don’t make the teens in our lives hug or kiss people they don’t want to. In fact, we actively tell them they don’t have to! Why is a 3-year old any different? This small aspect of our behavior with young children can help address the broader issue of child sexual abuse.

If you see something, say something. A lot of folks get into a “not my business” frame of mind when it comes to sexual abuse. This frame of mind, often called the bystander effect, is why we read stories about people who witness a violent crime and don’t intervene or call the police.

The thing is, any type of violent crime is everyone’s business. And when it relates to those who can’t speak up for themselves, it’s even more important that if we suspect something, we say something.

This is an especially important point for those who work with children on a regular basis. During the week of July 14, St. Joseph’s college is hosting an education symposium about child sexual abuse signs, symptoms and reporting. Speakers include Sen. Bill Diamond, Attorney General Janet Mills, Maine State Police Lt. Glenn Lang, former Assistant District Attorney Alan Kelley, and others.

I’ll be speaking about child sexual abuse response, prevention, and the importance of services such as Children’s Advocacy Centers and sexual assault support advocates. The information presented is intended for teachers and administrators and will include topics such as mandatory reporting and best practices for addressing a student/child who may be a victim. The symposium will be helpful for educators who have a chance to intervene in a potentially abusive situation. Both graduate and continuing education credits are available. For more information, or to register, click here.

The culture of silence around child sexual abuse still exists, though it’s getting better. For more information on how to prevent and respond to child sexual abuse, visit the Maine Network of Children’s Advocacy Centers, a program of MECASA.

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SAPARS Board President receives an award from the New England Patriots!

William Lowenstein (our Board President) of Auburn, Maine wins second place award of $10,000 for SAPARS in the Myra Kraft and New England Patriots Community MVP Charitable Foundation!

SexualAssaultPrevention_BillLowenstein_Field (Small)











Here is the official press release:

“FOXBOROUGH, Mass. — The Kraft family and New England Patriots Charitable Foundation’s Myra Kraft Community MVP Awards place a spotlight on those who give their time to help others and exemplify leadership, dedication and a commitment to improving their communities through volunteerism. Annually, the Kraft family and New England Patriots Charitable Foundation host the awards program as part of the ongoing Celebrate Volunteerism initiative in honor of Myra Kraft’s example of being a lifelong volunteer.

On June 9, 26 volunteers were recognized for their contributions at a luncheon and awards ceremony at Gillette Stadium. Each Community MVP received grants for their respective nonprofit organizations. Fifteen New England based organizations were presented with $5,000 grants in honor of their volunteers’ work. Ten others received grants of $10,000 and one grand prize winner was presented $25,000.

‘Every year, we ask New England nonprofit organizations to nominate one volunteer who they consider their MVPs,’ said Patriots Chairman and CEO Robert Kraft. ‘This year, we received a record number of nominations from over 400 nonprofits. Their stories are heartwarming and inspirational and narrowing the field to 26 winners gets more difficult every year. As a lifelong volunteer herself, this was always Myra’s favorite event. I am so glad that her legacy continues to live through the great work of all the Myra Kraft Community MVPs.’

On hand to congratulate the award winners was Patriots Chairman and CEO Robert Kraft, New England Patriots Charitable Foundation President Joshua Kraft, Pro Football and Patriots Hall of Famer and Patriots Executive Director of Community Affairs Andre Tippett, Patriots quarterback Tom Brady, Patriots linebacker Jerod Mayo and Patriots alumni and three-time Super Bowl Champion Joe Andruzzi.

William Lowenstein of Auburn, Maine was one of ten $10,000 second place winners.

‘It is a privilege and an honor to be recognized by the New England Patriots Charitable Foundation and with being entrusted with carrying on the legacy of Myra Kraft,’ said Lowenstein. ‘Volunteering has provided opportunities for creating personal growth and provided me with the chance to create positive change in my community while trying to establish a safe environment for sexual assault victims.’

As a founding board member, Lowenstein has been volunteering tirelessly to support those in need for thirty years. Being a survivor of childhood sexual abuse, he willingly opens up about his experiences to other male survivors. Lowenstein is able to build trust with victims and has made himself available to speak with other survivors while also serving as a community advocate, educating the public about sexual assault. He is able to touch upon a topic that people have trouble discussing and does so with heartfelt compassion. Despite being diagnosed with leukemia several years ago, Lowenstein continues to play a key role in shaping the organization’s prevention programming.

‘Sexual Assault Prevention and Response Services is proud and grateful that Bill Lowenstein is being honored with a Myra Kraft MVP award,’ said Marty McIntyre, Executive Director of the nonprofit. “The award not only recognizes and honors Bill’s 3 decades of work with and for our agency, but it also provides an opportunity for us to continue to raise awareness about sexual assault, including that it happens to males and that males can have a powerful role in helping to end it.’

The 2014 MVPs represent all six New England states, a variety of nonprofit organizations and range in ages from 13 to 93 years old. Nominations open each spring and for the most up-to-date information, visit”

(Congratulations, Bill!)

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