Nick Angelis: Hello, and welcome to the Ascend Health Show. I’m your host, Nick Angelis, I’m the Owner of Ascend Health Center. And I’m here with Jessica King from the Hope & Healing Survivor Center.
Jessica King: Hello.
Nick: How are you doing?
Jessica: I’m doing well, how are you?
Nick: Most importantly, happy fall you all.
Jessica: Happy fall.
Nick: I know that usually these shows are usable at any season, but I really liked this pumpkin, so I thought I’d bring him on the show with us.
Nick: But I’ll talk to you instead of the pumpkin, because otherwise that’d be a weird show and no one will watch it. So the first question I had for you was actually a new story from last week to get right to it. And that was, there was a commuter train in Philadelphia, where a woman had been hassled and then raped for 40 minutes while everyone else on the train was playing with their phones, maybe taking pictures and doing nothing to help her.
So obviously these are — it’s a very strange story. There’s a lot of, how could this happen? If I had been there, I would have done this or that, but what’s the appropriate reaction? How can we protect other people while also sometimes not intervening in cases, where we’re not supposed to, although that one was clearly, someone should have done something?
Jessica: Well, there are safety concerns, right? But it brings up a good topic and point about bystander and their intervention and how that plays a role, um, with sexual assault, other violence that might be happening within our communities. So a couple of things to keep in mind is that, you know, I-I brought up safety. How can I intervene without, you know, increasing the safety risk or putting myself at risk, but still try to help the person that’s being harmed.
I think that in the case of this story, it was a really awful, awful thing that happened. Um, but pretty much anything other than a lot of the bystanders, I think I read were taking out their phones, right, and recording it. And they didn’t, I think it — I think I read, they didn’t really get any 911 calls, or maybe just a few.
Um, so when we talk about bystander intervention, it’s important to think about what can I do, right, to help the person that’s being harmed? So couple of things that come to mind might be, you know, either maybe collaborating with the people around you and talking with them, how can we develop a plan to help this person, calling 911 that would probably be the first thing that you can do, um, to intervene.
And-and you know, if you feel safe, maybe providing some sort of distraction, um, to distract the-the perpetrator in this case. Um, but there are many other things that you could try, um, that hopefully could help intervene or distract.
Jessica: Um, if you don’t feel comfortable going and intervening first hand and involving yourself in what’s going on, a distraction could help or even calling 911, right? Um, so this was a really, really terrible news story.
Nick: Well, I think a lot of it too is you can always do a little bit. So it was only a few years ago that they came out with, um, compression-only CPR. Meaning that sometimes people would see someone just fall out and like, well, I don’t know what to do, I’m not really good at this. I don’t want to kiss this guy as far as CPR goes. And so I said, no, just get on his chest and start compressions and then you can figure out the rest, because obviously as a nurse anesthetist, it’s actually not easy at all to breathe for someone or to get air in and out, you have to have the right angle. And so this took out the complexities that would sometimes make people turn the other way and say, just do this simple thing. It doesn’t take much skill, just pump on somebody.
Nick: So, maybe a similar approach at work, where-
Jessica: Right, just doing something.
Nick: Because it is true and I saw the guy’s mug-shot. He really didn’t look like the type of guy that one person would want to like, just start intervening. It would be more of, um, like with the 9/11 attacks, how the plane that went down in Pennsylvania, was one passenger who said, look, guys, this is what we need to do. And then once they got a plan together, there is that paralysis of, well, nobody else is doing something, so maybe we shouldn’t either.
Jessica: Right, right. And it’s-it’s, uh, it could be considered a traumatic event, right, where you’re involved and you’re watching it happen. So you’re kind of stunted and trying to figure out what to do. But I think starting with the 911 call, and then talking to the person that you’re by, right, having-having a conversation in that moment, what can we do to help, um, I think is a good place to start.
Nick: Right. No, that-that makes a lot of sense, because that way you can build some consensus. And another thing too is because this particular story, the woman had been harassed for quite some time before anything happened was a little bit of that analogy, where he put the frog in the boiling water and slowly increase the heat.
People were like, well, this is awkward, but I’m not going to do anything. And then as it got worse, they already had made their decision. So, I mean, I guess this is applicable for different areas in life.
Nick: But there is that sense of, you know what, it’s not too late. Yeah and I made a decision, I can change it. This is different than when I originally said, look, I just got to mind my own business.
Jessica: Mm-hmm. Yeah, yeah. And when we talk about bystander intervention, it’s a topic that — topic that’s often involved in discussions about sexual violence and intimate partner violence. If you see something happening, what can you do to intervene or what can you do to potentially stop it?
Nick: Right. And it sounds like that’s a good summary for what to do if you don’t know the person, you know, reach out for help, involve the authorities. Uh, so when we start getting a little bit closer to home, what’s the best action, because I know a lot of what you deal with is domestic violence, but that’s maybe a better way to do it is let’s just take it step-wise. So stranger, call the police, cause a distraction, just to do something, even if it’s small and start there.
Nick: You don’t have to- And it’s important for me, because I tend to be the other extreme, might go punch the dude or something. So it’s good to know, okay, you don’t have — it doesn’t have to be this binary thing where you do nothing or start a fight and try to be a superhero.
Nick: What’s the correct approach if it’s more an acquaintance or someone you don’t know well, but you suspect that they’re having trouble or, um, that kind of situation.
Jessica: With intimate partner violence, what you say?
Nick: I’m almost there.
Nick: Now I’m saying about where you just have a friend, where you think things are going on that aren’t right, but you’re not sure what your role is. Because I think that happens a lot too where you’re like, well, I’m not really close enough to ask him, okay, what’s going on? Do I need to help you?
But at the same time, you’re close enough to care about this person. Sometimes that’s, um, kind of like a really difficult middle ground. Like I know my cousin is having some problems, what do I do about it?
Jessica: Mm-hmm. Yeah, I mean, I think that you could start with, if obviously if it’s not an immediate safety concern where you would need to call 911 or something of that sort, you could provide resources.
Jessica: Um, so you don’t need to ask them for every detail, right? You don’t need to ask them for exactly what’s going on. Maybe you have suspicions, maybe you say, hey, this is what I’ve noticed. If you want to tell me more about it, you know, I’m here to listen.
Jessica: Um, but here are some resources if you need them. Um, so you’re letting them know that you’re listening here. If there is something more serious going on, you can be a person that they can come to and they know that because you’ve voiced that.
Jessica: Um, and then just providing them with a resource. Maybe it’s the number to a place like our resource center, where we provide services for, um, survivors of sexual violence and intimate partner violence. Um, maybe it’s a hotline number, where they can call and just talk to a person anonymously, um, or providing education. If you have it, you can do that. Um, but if it’s something, you know, quicker, you’re kind of just having a conversation about it, providing resources and just letting them know that you’re a safe person to talk to.
Nick: Okay. So that safe person, is it important to make sure that there’s no judgment, for example, in that Philadelphia case, if I want to work out, if someone’s like, hey, come on coward, why don’t you help me beat up this guy? A lot of times that doesn’t result in the way you want. So even in that case, you’re saying — you’re not saying, hey, you need to leave this guy or here’s what you need to do or how could you let this happen? It’s more of a neutral, here’s some resources.
Jessica: Absolutely. And I think that that’s something really important; in that case, that was an immediate emergency, right?
Jessica: The police should have been called, absolutely. There should have been sort of some bystander intervention other than people just taking out their phones, which is what happened. Um, but in a — in a case where you might suspect something is going on, um, with intimate partner violence or sexual violence, you can provide the resources. But like you said, just letting them know that you’re there. Because I think a lot of times those-those particular situations can be incredibly isolating, especially intimate partner violence. Um, so you-you don’t want to pry necessarily. Um, but letting that person know that when they’re ready, if they’re ready, they can come to you and you’re a safe person, no judgment.
And I think that the other thing is no, um, try not to tell them like you need to leave, you need to do this, you need to do that rather than just offering them a safe space, because it’s already, like I said, it’s already so isolating. So you want them to know that they still have somebody, does that make sense?
Nick: Actually it makes a lot of sense, because that fits in with the example of CPR.
Nick: A lot of people don’t want to intervene, because they’re like, what do I do? Am I going to mess this up? And so that’s why now we say, just stomp on their chest, you’ll be fine. Instead of, well, do I need to put an airway? I don’t know how to put an IV? Do I need to find some epinephrine, someone on the street doing that sort of thing? Of course they’re going to be like, maybe I’ll just take a picture with my phone. So what you’re saying is you don’t have to have a solution.
Nick: You don’t need to know the answer or even have good advice, you just need to listen. And as you said, give resources. So what exactly are the resources that you all offer? Obviously we’re in the Akron area, but this show can go out nationally.
Jessica: Yeah. So our center, what makes it really unique, so where this — uh, Hope & Healing Survivor Resource Center, it’s kind of our umbrella term. Underneath that umbrella we have the Battered Women’s Shelter and the Rape Crisis Center, both in Summit and Medina County.
So we offer completely free services for survivors of either sexual violence, um, intimate partner violence or human trafficking. Um, so we offer free therapy services, we have advocacy. Um, our advocacy includes legal advocacy, um, family stability advocacy. We have our 24 hour 365 hotline. We have one for the Rape Crisis Center and one for the Battered Women’s Shelter. And we do a lot of community outreach. Um, we have campus services at the University of Akron. And, um, so I think what makes us really unique — of course we have our shelter as well, that’s one big thing that I had forgotten to mention.
We have our shelter, um, one of the biggest in the state and, uh, they offer wonderful resources for families and kids, um, as well. So it’s a safe, completely locked down and secured shelter for people to go to if they need to.
Jessica: Um, but again, what makes us unique is that all of our services are completely free. So I think that it’s hard to find, especially like counseling, for example, therapy, that’s just completely free, um, is-is a really, really awesome resource. All of our therapy, um, our whole therapy team is trained in a trauma-focused technique called EMDR that stands for Eye Movement Desensitization Reprocessing. So it’s a more intensive approach to trauma therapy. But it’s, again, something offered, um, if our clients want to utilize that for free.
Nick: Great. And that’s one of the reasons that I first contacted you was the EMDR and your trauma focus. Since at Ascend, we do so much with trauma using the ketamine therapy, counselors, psychiatry. So how can places like My Clinic, Ascend and all the other ones in the area, because of course we have a collaborative approach, how can we work more closely with you all? Like, is it more sending you patients who we feel like fit that criteria or how can we be a resource and also help you expand your reach?
Jessica: I think doing things like this, right? Like keeping in contact, having communication, um, you know, you are all welcome to send us referrals. Um, our referral process is very easy I think. Um, if you just contact our main business line, um, clients can just say, hey, you know, I would — I’m looking for therapy services, and they would be connected with our therapy, uh, our director of therapy services, which is — her name is Ashley Kline, yeah.
Nick: And it sounds silly like, well, what does it matter if it’s free? A lot of these patients are on Medicaid or therapy isn’t that expensive, but it goes back to what I was saying about the frog in the water. Sometimes even the smallest impediment to getting care just becomes this insurmountable task when all you can focus on is surviving or getting to the next day. And something as simple as, well, I don’t know where my insurance card is or as you said, it’s isolating. So in some cases, the person doesn’t have access to their own driver’s license or insurance.
Jessica: Sure, absolutely.
Nick: And I think that is something to point out that this isolation isn’t just that the person feels lonely. It’s often the one who is doing the abuse, trying to keep them isolated so they can come to you.
Jessica: Absolutely, that’s a very big piece of intimate partner violence.
Nick: So-so sometimes it is a little work for us trying to help someone, because there’s these almost purposeful barriers that the aggressor has made. So it’s not that easy to just like, oh, go to that place and they’ll help you, or why don’t you leave tomorrow?
Jessica: Yeah, yeah. And I think that in general, um, intimate partner violence and-and relationships and abuse within relationships, I think it’s something that we’re starting to talk about more, right, but I don’t think that it’s something that we talk about often. You know when we talk about healthy relationships versus unhealthy relationships, how often are we having that conversation? Um, maybe with our family, with our children, or like our teenage children, for example, um, even into adulthood, how often are we having conversations about what makes a healthy relationship versus an unhealthy one? How do we recognize red flags? How do we recognize if there’s gas-lighting or emotional abuse happening, because that’s usually the step-stone into the more physical violence?
Jessica: Um, in general, I think it’s just something that we could do a better job of-of talking about educating on, um, earlier in life.
Nick: Right. You’re right, because a lot of times we just assume what we saw model that’s we’re growing up is normal, that’s a standard.
Jessica: Right, yeah, exactly.
Nick: And so sometimes we even get drawn to what we’re used to even if it’s not healthy because somewhere the — our inner child or-or whatever the correct term is, is like, well, nope, this is what I’m used to. This is what feels comfortable even if it’s toxic.
Jessica: Right. And I think abuse, especially can-can be pretty cyclical. You know, if this was normalized in your childhood, it’s likely that it’s going to be continuously normalized into adulthood. And maybe with your partner as an adult and within your family, um, that’s not always the case, but it is — it is pretty normal to see that.
Nick: Is it, do you feel it’s a little different from person to person? How, for example, at my clinic, sometimes we have a patient with complex PTSD and we’ll look at their life history and it’s not something where, oh, this is a terrible thing. It’s simply that their brain just couldn’t process what happened and they never got dealt with.
Jessica: Absolutely, right. Yeah, yeah, I think absolutely every clients, um, that we see of course has, you know, we have specific things that, um, a client needs to have had in their history for us to see them, which is IPV – intimate partner violence or sexual violence or human trafficking, right?
So we know if we’re seeing them, there’s probably something in their history of that nature, right. But how the client presents is going to always be different. Um, especially when it comes to therapy and providing survivor resources, it’s not a one-size-fits-all. So you have to approach every situation, um, kind of as a blank slate, right, they might be coming in with this, but really meeting them where they’re at.
Nick: Right. So-so if one of our viewers is thinking right now, well, is this an abusive relationship? Where is that line again? Again, we just said, it’s a little different. But sometimes the issue is that, uh, in our culture we know just enough to be dangerous or I’ll have patients saying words like gas-lighting or abusive or toxic.
Sometimes it’s nope, this is normal life, and this is a hardship that you have to deal with. And sometimes this is your fault and it’s not, well, let me blame my parents or this origin or that thing that happened to me when I was seven. So where is that line between, well, here’s some personal responsibility. Um, and obviously it’s much more common that no, this is a bad thing you need to get out; not that, like, this is just life and you need to deal with it. But is there anything that you could tell someone watching, of like, again, not that this is a straight line of, or abuse ends and, or this is toxic, but how can we figure that out a little bit better?
Jessica: Yeah. So we have — we provide resources if I’m understanding like how can I recognize this earlier, well, there’s what’s called red flags. Um and how can you notice these red flags early on in a relationship? Um, that might be a sign that maybe this isn’t a healthy relationship.
So there are a couple of things. If-if clients are wondering, you know, am I in an abusive relationship, there’s all kinds of resources out there that we can kind of narrow down and see, um, what’s happening and is this abuse and how can it be defined? What does it look like? But in general, for somebody that might be questioning some key things that you can look for, are, am I being isolated? Is my partner, um, getting upset or making me feel guilty for wanting to see family or wanting to see friends? Um, are they possessive?
Am I being treated as if I’m an object rather than a person, um, extreme jealousy. And I think that this is all on a continuum, right? Um, but extreme jealousy, is my partner getting upset with me or is there a consequence if I want to see a friend or if I want to see my family member, um, or if I’m having a friendly conversation with somebody in a social setting? That is something to recognize as maybe a red flag.
Um, and I think that, again, I can on a continuum is important to recognize too, because jealousy, I think in some aspect can be normal in a relationship, but the key word is extreme.
Jessica: So a few more, I mean, there’s a whole gamut of these. But, um, just in general kind of keeping an eye out for little things like that, breakdowns in communication, feeling manipulated, feeling pressured too much too fast. Um, is this person telling me I’m their everything that they love me, and we’ve only been seeing each other for a couple of days or a few weeks, so just things like that.
Nick: And it almost sounds like the way that we describe syndromes in my practice, because a lot of our treatments, we have patients who are treatment resistant and they’ve come to us with mental health issues or pain, and they’ve been to multiple specialists. So this one said, oh, here’s what’s going on, but you don’t quite fit the label for this. And you probably have this disease, but then again, this symptoms wrong.
And a lot of it’s like, well, what’s the root cause? Maybe you don’t have the symptoms. So it’s not the fibromyalgia or maybe we think its complex regional pain syndrome, but you’re lacking this. But you have to kind of look at the whole picture of what’s the constellation. Sort of what you were saying about jealousy, you’re saying it’s not jealousy and isolation and there’s nothing else toxic. It’s — maybe there’s a little bit of this and a lot of that. But when you kind of step off, like step out a little bit, you can see, okay, all of this together means that you’re in a bad situation.
Jessica: Right, mm-hmm. So if you have concerns, my suggestion would be to have conversations with people that know you, maybe not necessarily for advice. Um, but just like, hey, does this seem off to you or what do you think about this? If you don’t have people that you feel comfortable, um, contacting an agency like ours, if you have questions kind of decipher, is this abusive, um, every relationship is so different.
Jessica: So it’s going to depend on the individual. Of course we have things that we know are just more outright abusive, but each relationship is different. So just having conversations about it can be helpful.
Nick: And I think a lot of what we’re saying today is — don’t wait until you’re getting hit, like you’d start this process of what’s going on. And really even before they — because it can be dangerous to leave, it sounds like part of figuring this out and making a plan is to contact your office.
Nick: And to start gathering resources and really weighing your options. Because I think in the end, everyone makes their own decisions.
Jessica: Yeah. And-and you bring up a good point about safety and it might not be safe to leave. I think that’s also a unique piece about our agencies that we meet clients where they are. I think in general when we’re talking about abusive relationships, the natural response that you might want to say to somebody, especially if you’re close to them, if their loved one, just leave, right?
Just get out of the relationship. Um, why are you still with that person? Um, but we really understand the-the cycle of abuse and the trauma bond that could occur. And we know that sometimes it’s not the safest, it’s not the right decision at that moment for that client to be leaving the — to be leaving the relationship. Um, so, we have this unique understanding about trauma and about abusive relationships. And so clients can come to us without fear of judgment, without fear that we might tell them to leave the relationship.
Jessica: Um, because regardless of where they’re at in that, um, in that situation with that person, we will still help them. We will meet them where they’re at. If they’re still in the relationship, they’re needing help getting out, or they’ve been out for 10, 20 years and they have this trauma that they need to deal with, um, that that’s gone on process for all those years. So regardless of their situation where they’re at, um, we will help them.
Nick: Well, that’s really neat, because you’re right. A lot of grief and trauma, it doesn’t fade with time, It just gets buried and comes out in strange ways where even your friends and family can’t help you because they’re not recognizing the root of it.
Jessica: Right, right.
Nick: The type of syndromes I was talking about. But what’s the real cause we can treat symptoms and give medications all day. But sometimes the answer isn’t, you know, opioids or Prozac, it’s simply, let’s talk about this, let’s get to the root and then let’s move forward. And it really sounds like a harm reduction strategy.
Nick: We do, uh, we work with substance abuse and a lot of it is, well, where are you and what’s the next best step? Not an immediate, okay, you need to stop doing this today. Those patients won’t come to us because I’m just going to be told I can’t do cocaine anymore and they’re not ready for that yet. It is a process sometimes. Well, we’re almost out of time. Is there anything else do you want to tell the people so to speak?
Jessica: Um, I think just in general, if you are a survivor, we are here for you, Hope & Healing Survivor Resource Center is here for you. Um, and if you’re a co-survivor, just try to remember that, you know, just be a listening ear, right? Be a listening ear for your loved one, for your friend, for your family member that might need you, and I think that that’s — yeah.
Nick: Yeah. And I think that’s a really good summary of what we’ve talked about today that you know, this is meant to be educational, but it’s not okay if all the tools, go help your friends. It’s what you said, I mean, even in that example of the train that we started with, all you have to do is listen, and start with it.
Jessica: And have to be a good bystander, right, yeah.
Nick: Right. And if you’re not listening, if you’re just so focused on your own life or whatever is going around, then you do a disservice to not only your intimate partners and your friends, but even strangers who might need you. So yeah, that’s really good. Well, thanks everyone. This has been the Ascend Health Show and we’ll see you next time.
Jessica: Bye, thank you.