Healing process after rape never ends

March 21st, 2013

By Jacque Wilson, CNN

When the judge’s gavel fell, the future had been decided for the two teenagers convicted of rape in Steubenville, Ohio.

Trent Mays, 17, and Ma’lik Richmond, 16, will spend at least a year in a juvenile correctional facility, although authorities could decide to keep them in custody until they turn 21. Both must undergo treatment and will have to register as sex offenders.

For the 16-year-old victim, the next steps aren’t so clear.

She was raped last summer at a party; witnesses posted images of the assault on social media. The case has garnered national attention and sparked a conversation about rape in America.

“My family and I are hopeful that we can put this horrible ordeal behind us,” the victim’s mother said Monday. “We need and deserve to focus on our daughter’s future.”

Every two minutes, someone in the United States is sexually assaulted, according to the Rape, Abuse and Incest National Network. Every survivor responds differently to rape, says Jennifer Marsh, vice president of victim services for RAINN, the nation’s largest anti-sexual-violence organization. Emotions run the gamut from fear to anger to guilt.

“It’s such a violent and personal crime,” Marsh said. “It’s not somebody just breaking into your house. It’s somebody assaulting the most private part of you. Having that be public, especially as a minor, can be traumatic.”

Victims of sexual assault are three times more likely to suffer from depression and six times more likely to suffer from post-traumatic stress disorder, according to RAINN. Some try to self-medicate with alcohol or drugs. Many have trouble with intimacy and forming trusting relationships.

One of the most common issues survivors face is blaming themselves for the assault, Marsh says. A lot of that has to do with our culture: Marsh says she sees rape cases like the one in Steubenville every day that aren’t taken seriously.

“A lot of times, it gets chalked up to, ‘Oh, kids will drink, and things will happen,’ ” she said. “But … sexual assault is sexual assault. And it doesn’t matter if the victim was drinking or using substances. The fact is that something was done to her that she didn’t want to be done. And I think that’s the conversation we really need to talk about.”

The victim in the Steubenville case has endured hostility from the attackers’ supporters. Although mainstream media have kept her name private, it’s obvious she’s well-known in the small Ohio community.

Defense attorneys questioned the victim’s character on the stand, asking witnesses about her alcohol consumption that night and what she told them the next morning regarding the assault. They also attempted to bring the victim’s past into the trial, but the judge did not allow the line of questioning.

The character attacks weren’t over after the verdict was read. Shortly after the trial concluded, two teenage girls were accused of making threats against the victim on Twitter, according to Jefferson County Sheriff Fred Abdalla. One of the girls was charged Tuesday with one misdemeanor count of aggravated menacing for threatening the victim’s life.

This kind of personal persecution is a big fear for victims, says Becka Meier, a licensed professional counselor with the Women’s Center, a large nonprofit crisis center in Fort Worth, Texas. More than half of sexual assaults are not reported to the police; experts estimate that 97% of rapists don’t spend a day in jail.

“When we have a high-profile case that gets reported and we see the victim be re-victimized … it makes it all the more difficult for victims to come forward,” Meier said. “Survivors are faced with that difficult decision: Am I ready and willing to be in a courtroom and face this and talk through all the details again in such a public forum? It’s a lot to ask.”

Meier says a guilty verdict often offers survivors a sense of validation — that someone, at least, believes them. “Does it provide closure for a victim? I’ve never seen it provide closure,” she said. “It’s just a step in the healing process.”

That process never ends, Meier says. Photos of an attack that are posted online can make it even more difficult, acting as triggers to bring back painful memories each time they resurface.

“As hard as they try to delete or erase those images, five, 10, 15 years down the road, they’ll be notified that it’s popped up again and in some ways they feel like they’re reliving that assault,” Marsh agreed.

How a victim’s support network responds can have a big impact on the long-term recovery for that survivor.

“The first thing that loved ones should do is believe what the victim has said,” Marsh said. “Although we know it’s natural to try to figure out exactly how this happened, we encourage loved ones to avoid using ‘why’ questions, because victims often perceive that as blaming them for what happened.”

Family and friends should also recognize that each victim needs to recover at his or her own pace, she says. They should provide love and support without forcing them to do something that they’re not prepared to do yet.

Survivors can contact RAINN through their National Sexual Assault Hotline or go to online.rainn.org. Many local crisis centers offer individual/family counseling services and support groups.

Rape isn’t something survivors get over, Marsh says. But counseling and a solid support system will help them move on.

“Although they may never be able to forget that this happened, it doesn’t have to define who they are or the choices that they make.”

How is PMS Impacting Your Life and What Can You Do to Change it?

March 20th, 2013

By Dr. Daemon Jones

Have you ever had cramps a few days before your period started? Or maybe you have mood swings you feel irritable or angry prior to your period.

These are different symptoms that we can have as a result of premenstrual syndrome (PMS). According to the Mayo Clinic it is estimated that 75 percent of women experience PMS symptoms about a week before their period begins.

These symptoms are variable and often resolve when menstruation begins. PMS is hard to define because there are so many different symptoms that can show up for women.

Every women’s PMS can be very personal and very different, generally falling into emotional or physical symptoms.

Emotional symptoms may be crying spells, depressed mood or mood swings, social withdrawal poor concentration, changes in appetite or food craving, tension, anxiety, irritability or anger.

Examples of physical symptoms include cramps, tender breasts, fatigue, fluid retention weight gain, joint, muscle or back pain, headaches, acne, constipation or diarrhea and abdominal bloating.

Do you know what contributes to your PMS symptoms? Factors that create the symptoms related to PMS are chemical changes or behavior habits.

Chemical changes can include hormone fluctuations and often change during pregnancy or menopause. Chemical changes in the brain could result from undiagnosed depression or changes in neurotransmitters in the brain.

Behaviors like poor stress management or poor eating habits can trigger PMS symptoms.

While you might not be able to influence the chemical changes you do have control over the behavioral habits that impact your PMS.

Wouldn’t you want to make an impact on your PMS symptoms just by changing your behavioral habits? You can, by being more aware of the foods you are eating and creating stress management

Dr. Daemon Jones is a Naturopathic Physician who treats patients all over the country using Skype and phone visits. She helps her patients cultivate health and feel great, using a combination of safe and effective naturopathic and conventional methods.

What Really Causes Violence in Psychosis?

March 19th, 2013

A new study investigates how anger associated with delusions — not simply being out of touch with reality — is critical in determining whether psychosis turns violent.

The research, published in JAMA Psychiatry, included 458 participants around age 31 who experienced a first episode of psychosis in East London, an inner-city neighborhood with a history of poverty and social stress, between 1996 and 2000. They were diagnosed with some sort of psychosis either through local mental-health services and hospitals or via the criminal-justice system.

Schizophrenia and schizoaffective disorder — a condition that includes the delusions and social withdrawal of schizophrenia, along with a mood conditions like depression or bipolar disorder— together accounted for more than half of the participants’ diagnoses. However, 14% suffered from psychotic depression, a condition in which delusions develop as part of a severe depression, and 10% had bipolar disorder in which a manic episode included psychotic delusions. The rest were diagnosed with a variety of less common psychotic conditions.

Nearly two-thirds of the participants were not involved in any violence at all in the year before their first psychotic episode. But 26% had committed what the authors defined as minor violent acts, including assaults that did not lead to injuries or involve weapons. Another 12% were seriously violent, engaging in crimes like injurious assaults, use of lethal weapons or sexual attacks.

The researchers, led by Dr. Jeremy Coid, a professor of psychiatry at Queen Mary University in London, interviewed participants about the content of their delusions and their emotional experiences. Anger related to delusions was strongly linked with attempting to harm others. After adjusting for other factors, 31% of the minor violence could be attributed to anger connected with delusions. In the seriously violent patients, anger accounted for 56% of the incidents. Elation, anxiety and fear were not associated with violence.

Those who engaged in violence also tended to be younger and were more than twice as likely to have taken drugs in the past year, although alcohol use did not matter. The seriously violent were far more likely to be male, but there was no difference in risk by gender for minor violence.

None of the delusions were dangerous in and of themselves. But three types, all of which involved a sense of personal threat, were linked to serious violence if they provoked anger. One delusion centered on the idea that the person was being spied on or was under surveillance by some type of threatening authority, group or person.  Another focused on the misguided belief that people with hostile intent were targeting the victim. Finally, there was the fantasy of some sort of conspiracy against the delusional person.

Any anger generated from feeling threatened under these situations could make the patients lash out. “Anger due to delusions appeared to constitute the main drive to serious violence,” the study authors write. On the other hand, a more depressive response to the threats seemed to thwart violence so that a “depressive affect had a protective effect,” according to the research.

“If patients are not angry, the delusions themselves don’t cause a problem,” Coid told the New York Times. What causes delusions to result in angry responses in some people and not in others? Researchers aren’t sure, but they believe that a better understanding of this connection, as well as a greater appreciation for how this anger response is related to the delusions of psychosis, could lead to treatments that prevent violent behavior and its potentially tragic consequences.

What to do after an affair

March 18th, 2013

By Ian Kerner, CNN Contributor

  • Infidelity is much more complicated than our culture admits, expert says
  • Couples can find their way to a deeper and more intimate bond after an affair
  • You can’t heal from infidelity overnight — take time to rebuild the relationship slowly

Editor’s note: Ian Kerner, a sexuality counselor and New York Times best-selling author, writes about sex and relationships for CNN Health. Read more from him on his website, GoodInBed.

We’ve all heard the adage: “Once a cheater, always a cheater.” If your partner has been unfaithful, you’re likely getting all sorts of advice from well-meaning friends and family.

Much of that advice may involve ending your relationship. Yet it’s possible — and perhaps even beneficial — to stay in a marriage or long-term relationship when one partner cheats. That’s the idea of two new books from noted experts on the topic: a newly revised edition of the best-selling “After the Affair” by Janis Abrahms Spring and “The New Monogamy: Redefining Your Relationship After Infidelity” by Tammy Nelson.

But should you really forgive and move on after infidelity?

“Most of us are totally unprepared for what lies ahead in a relationship, and ignorant of what’s required to last the course,” Spring writes. “An affair shocks us into reality. Fortunately, it also invites us to try again.”

Adds Nelson, “Many couples instinctively know that infidelity is much more complicated than our culture sometimes admits.”

Couples can, and do, often find their way to an ultimately deeper, more intimate bond — but it can take time and effort.

“In the wake of infidelity, most betrayed partners feel surprised and caught off guard,” says marriage and family therapist James Walkup. “But even though the hurt person may have assumed they would not stay married to a straying spouse, they may realize they still love their partner and want to work on the relationship.”

Today, not all committed relationships follow the traditional definition of monogamy. For example, both partners may decide together what constitutes cheating going forward — whether that means flirting with a particular friend, visiting a strip club or even having sex outside the relationship.

“I have seen a growing number (of) straight and same-sex couples thrive on the infamous ‘monogamish’ agreement,” psychotherapist Jean Malpas says. “They realize that long-term relationships might need to include the reality of attractions to other people. They carefully define trust and craft guidelines for acceptable behavior based on their level of comfort with risk and fluidity.”

Such a “monogamish” approach tends to be more common among gays, lesbians, bisexuals and transgendered people, notes sex therapist Margie Nichols.

“The issue is commonly on the table for consideration or discussion when LGBTQ partners get together, and when a transgression is purely sexual (as opposed to emotional), it may be less likely to end the relationship,” she says.

That’s not to say that monogamish couples are safe from infidelity, however.

“Just because a couple is monogamish does not mean that they will be any more forgiving of a partner who breaks the rules and violates their trust,” says social psychologist Justin Lehmiller. “Deciding whether to work things out has less to do with the gender of the partners and more to do with whether it was a good quality relationship to begin with.”

Nelson adds, “Ideally, your relationship will continue to grow and change as each of you grows and changes, and it may change position on the (monogamy) continuum throughout the years.”

You can’t heal from infidelity overnight. Instead, take time to rebuild your relationship slowly. Rather than ignoring the affair, be willing to share your pain, listen to each other and provide comfort when one partner is remembering the betrayal — all can help lessen the pain while re-creating the original bond that joined the two of you together.

“Turning your back on a damaged relationship may be the simplest or most sensible solution, one that frees you from the tyranny of hope,” Spring writes. “But it also may be a way to escape growing up, facing bitter truths about life, love and yourself, and assuming the terrible responsibility for making your relationship work.”

Some couples undoubtedly view an infidelity as the end of their relationship — and in some cases, going your separate ways may be the best decision. But for partners who are willing to recommit themselves to each other, an affair can be a turning point.

“Sometimes my clients acknowledge that coping with infidelity was the worst and yet the best thing to happen to their relationship,” Walkup says. “The distance between them has been bridged, and a deeper level of sharing and intimacy can bring joy and hope in the long run.”

Prostate cancer ‘damages sex life’

March 18th, 2013

Around 160,000 men in the UK have been left with little or no sex life after treatment for prostate cancer, the Macmillan Cancer Support charity says.

It suggested rising cancer rates meant cases could more than double by 2030.

Yet many patients could be helped if more services were available on the NHS, it said.

Erectile dysfunction is a potential side-effect of surgery, radiotherapy and hormone therapy used to treat the condition.

More than 40,000 men are diagnosed with prostate cancer in the UK each year.

In some there may be permanent nerve damage, meaning they cannot maintain an erection.

In others the physical problem can be temporary while for some the treatment has led to a psychological barrier to sex.

Two in three prostate cancer patients say they are unable to get an erection.

Macmillan said men also needed to feel they could seek help when they were having problems with sex after their treatment.

‘Lonely journey’

Jim Andrews, 63, a prostate cancer survivor from London, said his first reaction to his diagnosis of the disease was that it would kill him.

“The thought of libido-killing drugs and sexual dysfunction still seemed minor in comparison to the alternative.

“By the time I realised I was likely to survive, my sex life had been destroyed. I was devastated.

“It was not a subject that any professional talked to me about. It’s been a lonely journey as no-one talks about it.”

Professor Jane Maher, chief medical officer of Macmillan Cancer Support, said the figures showed that this was a major problem facing patients after their treatment and not enough was being done.

“The sheer volume of men affected shows the need for careful discussions before treatment.

“Many can be helped through early intervention and better support for men living with or beyond prostate cancer,” she said.

The charity wants to see specialist nurses, better psychological support and physiotherapists more widely available to prostate cancer patients.

It says men should also be encouraged to seek help from their GP when they are having problems.

Dr Daria Bonanno, a consultant clinical psychologist funded by the charity, said: “For many men with prostate cancer there is a certain stigma attached to talking about erectile dysfunction.

“Many may feel a sense of loss of masculinity and sadness around the inability to sustain an erection and will be reluctant to seek support.

“This can often cause them to emotionally isolate themselves from their partners and could make the issues worse.”