Slow Listening and the Context of Anguish

 By David S. Prescott, LICSW

ATSA member Kris Vanhoeck published a fabulous article in the most recent edition of ATSA’s newsletter, The Forum. Titled Slow Listening to Persons Who Committed a Sexual Offence, he explores the importance of what he terms “slow listening.” He states: “While studying about listening and listener skills I came across the concept of ‘slow listening’. Stemming from movements like Slow Food or Slow Living, Slow Listening is about finding new forms of awareness regarding sound consumption.”

The idea of slow listening is not itself new (Vanhoeck points to the work of Carl Rogers). There have been, for example, areas of the 20^th century musical world that referenced “deep listening” (see the work of Pauline Oliveros). Vanhoeck, however, places it into an entirely new context:

Making time for careful ‘forensic listening’ is a compassionate act of Unexpected Kindness. Kindness in respect to the person in front of us, not of the behaviour that brought him/her here. I’m here for you - you can choose to talk, you are in charge, you own your story - we have time - I will listen. Kindness is an essential part of Non-Violent Resistance. Nelson Mandela refers to the South-African Ubuntu tradition (Nussbaum, 2003). In essence, Ubuntu is a Nguni word for interconnectedness, for our common humanity, and the responsibility to each other that comes from our connection. In his opening speech on 26 May 2007 to launch The Elders, Nelson Mandela expresses his belief that “whatever techniques they use, in the end it is kindness and generous accommodation that are the catalysts for real change” (The Elders speech). In this way, unexpected kindness can be a powerful tool (Vanhoeck, 2019).

This observation is timely. Just this week, the New York Times published a suite of articles highlighting how “mental health” issues can be about far more than personal pathology. Earlier this month, The Guardian ran an article titled, “I’m a psychologist – and I believe we’ve been told devastating lies about mental health.” Its primary message is that, “Society’s understanding of mental health issues locates the problem inside the person – and ignores the politics of their distress.” The article provides interesting observations, such as:

If a plant were wilting we wouldn’t diagnose it with “wilting-plant-syndrome” – we would change its conditions. Yet when humans are suffering under unlivable conditions, we’re told something is wrong with us, and expected to keep pushing through. To keep working and producing, without acknowledging our hurt.

 My quibble with the language above is that while we can always talk about the politics of distress, it can easily distract us from understanding and empathizing with the context in which this distress exists. Whatever the political dimensions, these times (economic uncertainties, climate emergency, war, the pandemic and other infectious illnesses) are stressing just about everyone out. Importantly, this includes our clients. As we go down our list of proximal indicators of impending risk – escalation of negative mood, disappearance of social supports, emotional collapse, etc. – it seems that we really do live in times when even more external factors are influencing risk.

Privately, I have wondered if the media attention to our collective “mental health” in the current times hasn’t come into existence because the problems long faced by marginalized people (those of color and with minimal power and privilege) have now entered the mainstream of society. Whatever the case, we may have an opportunity to better empathize with our clients, especially those in the community. It is certainly true that many are in difficult circumstances secondary to their own actions. On the other hand, it can be easy to overlook the nearly insurmountable challenges they can face.

Whatever the case, Mr. Vanhoeck’s article, along with the recent attention to mental health by the media, remind us that sometimes the best risk management, as well as the best therapy, can be as simple as a relationship marked by long, slow, deep listening and understanding.

 

 

 

 

The evolution of Rape laws in Spain.

By Kieran McCartan, PhD., Kasia Uzieblo, Ph.D., and David S. Prescott, LICSW

We know that victims of sexual abuse – adults and children – do not always come forward to disclose their abuse and seek justice for what has occurred to them. This can have long lasting psychological, emotional, social, and health implications for them and often the people around them. Research and practice have provided ample evidence of why people do not disclosure, but a main reason is often that they don’t feel they will be believed or treated respectfully. One of the challenges that the criminal justice system often faces is proving a lack of consent. Cases often do not get beyond a police investigation, or they might get derailed in court. The net result is that we have a very poor understanding of the prevalence of sexual abuse both globally and country-by-country, with prevalence studies based on official and/or self-report data only being able to tell us so much. Therefore, there need to be new methods for improving the reporting and prosecution rates for sexual abuse and rape. In Spain, they are changing their approach by changing their national consent laws and the legislation that accompanies them.

In line with other countries, Spain is changing its consent laws from one based upon proving that consent was not given to ones proving that consent was given, known by the slogan, “Only yes means yes”. This means that all sexual encounters need explicit consent from all parties before they occur. The reason for this change in approach was an infamous case from 2016. In Spain, it is referred to as the “wolfpack” case, named after the WhatsApp group that the men involved called themselves. In 2016, five men gang raped a 14-year-old girl and , and recorded the rapes on their mobile phones. The video evidence indicated that the men were on the streets looking for someone to victimize. Upon selecting the girl in question, they led her off the streets to a secluded basement and raped her multiple times.

In court, it was revealed that there were seven videos, totalling 96 seconds. One of the men posted on their WhatsApp group what they had done, boasting about it and another of the men posted messages in a WhatsApp group celebrating what they had done and promising to share the recordings. There is no argument about what the men did or the age of the victim; the issue became what the girl didn’t do. The police report stated that the victim maintained a "passive or neutral" attitude throughout the scene, keeping her eyes always closed. When the case got to court the men were acquitted on rape charges, as they did not appear to use overt violence and because the girl was drunk and did not resist. Spanish law states that it is not rape if it does not involve overt violence or intimidation.

The men were jailed for nine years for sexual assault, which has a different legal standing and threshold. Not surprisingly, this was seen as too lenient and led to calls for a retrial and mass protests on the streets of Madrid with women’s rights activities arguing that it has made Spain less safe for women.

The trial led to a reconsideration of Spanish rape laws which are understandably seen as outdated and unrealistic, not evidenced-based, reinforces rape myths and misperceptions, and is nether trauma-informed nor compassionate in nature. The new “only yes means yes” legislation passed in the Spanish parliament means that “Consent can no longer be assumed to have been granted by default or silence.” This means that Spain’s rape and sexual harassment and sexual assault laws come into line with each other. it also means that people who have been victimized will no longer have to prove that they experienced violence, intimidation, or distress in the rape which is more appropriate.

Research has indicated over the years that people respond to rape and sexual assault in different ways and at different paces, which means that the reaction at the time is not necessarily as prescribed as the courts may want it to be. Therefore, it is important that we understand the individual’s perspective and take into account their narrative about what happened at the time. The other benefit of a consent-driven rape law is the removal of ambiguity because it focuses on the action not on the outcome; there is clarity around behaviour and expectation. In developing this law Spain is joining a number or countries and regions looking to change their sexual abuse and rape laws to be more victim oriented and consent driven. For instance, in 2018 Sweden changed its law which now states that the lack of consent is enough to constitute a crime (the ‘consent law’). Hence, all participants need to have actively signalled consent. Similar changes have been observed in Iceland, Greece, Belgium, and the Netherlands. In Sweden, this has led to a 75% rise in rape convictions according to some sources.

The question now is what next? what will Spain’s public education and community engagement strategy be around consent? How can consent take place? This legal change is considered by many commentaries as the next step in Spain’s response to the #MeToo movement, but that begs the question of what other preventive and responsive approaches to sexual abuse and sexual harassment will they develop?

Setting the Standard for Disclosure in Treatment

By David S. Prescott, LICSW

Recent weeks have seen at least three discussions in various forums of how – and whether – to treat individuals who are denying, minimizing, or simply don’t want to discuss their past behaviors. Where exactly do we set the bar for entering treatment? When one provider has stated strong recommendations for treatment that involves possible risks to others, is it ethical for another provider to treat something else at the client’s request, thereby very possibly not addressing what appear to be the more serious issues? Many practitioners have asked how they can hold a client accountable when they severely minimize their behaviors.

It's important to say from the outset that there are no clear answers, only more questions. Some programs require that clients be ready, willing, and able to discuss their past behaviors from the outset. All other things being equal, this can be unassailably standard practice, particularly in settings that can’t provide treatment to everyone who is referred. Of course, one might well ask: Are we missing opportunities to reduce risk among others who may look at first like they are denying or minimizing their actions when just below the surface they want to change but don’t yet know whether they can trust the treatment process.

The landmark 1998 meta-analysis by Karl Hanson and Monique Bussière found not only that denial was not a risk factor, but that failure to complete treatment is correlated to increased risk for sexual re-offense. The revelation that denial did not emerge as a risk factor continues to surprise professionals entering the field to this day, and many interesting papers have resulted from this finding. With some smaller exceptions, this overall finding has not changed. However, taken together, accepting someone into treatment who denies their offense and then terminating them adversely when they don’t confess may actually increase whatever risk is present. A more balanced approach is needed.

To that end, a number of approaches have emerged. In 2012, Ware & Mann recommended viewing disclosure as a process and not necessarily an event. They observed that there are many reasons why a person might not readily take responsibility for their actions and argued that over-emphasizing disclosure might actually be harmful. Still, clients who deny or minimize their actions can often be turned away by treatment providers who find their denial morally objectionable. Much has been written on these issues, including a recent paper by Ware & Blagden (2020).

One psychologist, in a recent training, summarized his thoughts about working with high-risk clients: “If they can disclose anything about what was happening at the time of their crime, I can work with them.” Others have described how working on the various criminogenic needs of each client even in the absence of disclosure might be sufficient to reduce risk (although one could not call it “abuse-specific treatment”).

What options are there? While a blog post cannot adequately cover what is available throughout the literature, some ideas for moving forward include:

• Starting by conducting an assessment. In the arena of treating drug and alcohol use disorders, it is well known that simply engaging in an assessment can reduce substance use. Explorations around what it would mean for the client and their loved ones if s/he did disclose might yield useful avenues for further discussion. Some motivations for not disclosing are easier to overcome than others.

• Likewise, it may simply be the case that the client becomes willing to disclose more information as the therapeutic process unfolds.

• The therapist can use their knowledge of risk domains (for example, impulsivity, negative emotionality, suboptimal coping skills, etc.) to help the client build strengths that may protect against any further offending.

• Important to remember is that simply being in treatment means that there is someone in the client’s life who can help them be aware of warning signs that something bad might be imminent (emotional collapse, financial issues, collapse of social supports, escalations of negative mood, etc.).

• Even absent any discussion of past crimes, therapy could be a venue for discussing sexual health and responsibility, masculinity/femininity, etc. Building strengths in these areas could be a further protective factor.

What is that compelling treatment in the absence of any agreement on treatment goals or methods is likely doomed from the start. Further, a 2008 meta-analysis found that more coercive treatment methods were less likely to work.

In the end, each program and professional needs to confront many questions, including the potential harms of denying treatment to people who might benefit from it, and to what extent our own attitudes and beliefs may prevent effective treatment provision that can benefit clients, the community, and those who have been victimized alike.

 

 

 

 

Current Prevention Trainings Aren't Reaching College Men: Four Things Colleges and Universities Can Do to Change the Culture.

 By Silvia Zenteno (Director of Educational Programs and Training at It’s On Us)

Colleges are not doing enough to prevent and address gender-based violence on their campuses. Last school year, we saw hundreds of campus-wide protests with students speaking up to tell their institutions what they need and what is or is not working. Students deserve more than to just be told, "Thank you for sharing your story," which our research has found happens all too often. We have also found that in response to gender-based violence on campus, colleges and universities often prioritize their own reputations and checking the box on Title IX requirements, rather than protecting survivors or investing in prevention training to address campus sexual assault in the first place.

 

Sexual violence happens every day in the United States and around the world, and our existing approaches are not working. It is time to do something about it. It’s On Us, a leading nonprofit in college campus sexual assault prevention started by then-Vice President Biden in 2014, recently released research that colleges can use to improve their prevention programming on campus, and if campuses start implementing these findings and recommendations now, it is possible to prevent an incident from happening tomorrow.

 

Since our initial launch as an initiative of the Obama-Biden administration following recommendations from the White House Task Force to Prevent Sexual Assault that noted the importance of calling everyone into the conversation on sexual assault prevention, It’s On Us has grown into the nation’s largest nonprofit program dedicated to college sexual assault prevention and survivor support while activating students on hundreds of campuses in our awareness and education programs.

 

In this work, we recognized that, to date, no major study had been completed to evaluate the attitudes and perceptions of students who participate in their schools’ prevention programming, and whether this programming impacted their behaviors.

 

That’s why we recently released our Engaging Men: National Campus Sexual Assault Attitudes and Behaviors Report, a first-of-its-kind study exploring the attitudes and perceptions of male-identifying students and their likelihood to get involved in the prevention of gender-based violence on campus. This research collected information on the types of prevention programming schools are conducting, as well as their effectiveness, reach, and possible gaps by using an exploratory qualitative method to better understand the experiences, attitudes, and behaviors of young college men.

 

We partnered with HauckEye, a consulting and insights firm, to conduct in-depth, one-on-one interviews with college men representing diverse campus communities. A benefit of qualitative research like this is its ability to explain behavior that cannot be easily quantified by allowing participants to detail their experiences and feelings.

 

This study found several important insights:

●    Men generally aren’t aware of the extent of the problem on their campuses: Most participants were unaware of the extent of sexual violence on campus. While some schools have had high profile incidents, several respondents thought these were all isolated incidents. Framing the issue as solely a Greek life problem means that many participants did not think the issue affected them or their school.

●    Current trainings are inadequate: The vast majority of participants reported that the prevention trainings they received, often online-only, were boring and ineffective. Positive prevention education experiences were in-person and included an interactive component like a certification. One student spoke highly of a comedian who came to campus and did a stand-up set about her own assault.

●    Men benefit from close relationships with non-male friends and role models: The respondents most attuned to the issue of sexual violence had strong friendships with women on campus. Co-ed sports teams, for example, foster an equitable and inclusive environment on campus between participants across the gender spectrum, leading to less objectification. By contrast, respondents reported that male-only groups like fraternities incubate toxic masculinity, such as misogynistic views toward non-male peers.

●    Men are too often at a loss as to how they can best help: The men in the study expressed a desire to help but didn’t feel they had the right tools to intervene. They expressed interest in training that would teach them how to intervene and deescalate situations involving sexual violence. The majority see themselves as moral people and want to do the right thing, but they just don’t know how.

 

It’s On Us intends for this study to be used to create actionable change in campus sexual assault prevention education. Below are four recommendations for colleges and universities to build more effective sexual assault prevention training programs:

 

1)    Use creative training methods: Implement more creative training methods, such as bringing a comedian to campus. Several respondents also reported that certifications for completing training helped them feel more involved. Most respondents reported that their prevention training was boring and did not feel relevant to their campus lives.

 

2)    Train in-person: Whenever possible hold trainings in-person to increase comprehension. Participants reported that online trainings were unengaging and ineffective. Several said they barely paid attention and passed the requirements easily.

 

3)    Combat assumptions: Students at smaller universities, commuter campuses, and religious schools did not think sexual violence was a major issue on their campus. Some also saw violence as solely a fraternity problem. Combating assumptions like these is key to helping men realize the extent of the problem and the need for intervention.

 

4)     Build connections: Men with strong ties to women and other non-male identifying people in their life felt more responsibility towards others and anger at other men who perpetrate violence. Ensuring that men, women, and gender nonconforming students are fully integrated on campus helps establish that non-male identifying students are seen as more than objects.

 

While this research focused on American colleges and universities, this is a global problem that will also require worldwide initiatives and action.

 

Schools can use these recommendations to make a change today. It’s On Us will continue to build on this research and conduct a large-scale quantitative survey to conduct further research of American colleges and universities and develop prevention education programming that educates and empowers everyone, including young men, to be a part of the solution.

A Closer Look at the “Minor-Attracted” Controversy

By David S. Prescott, LICSW

As I contemplated writing this blog post, I received the following email:

Subject: I am sick and need help

I am a pedophile using an alias. I cant stop with my thoughts against kids and its ruining my life. Please help me

I have no idea who this person is and a Google search on the email address provided no clue at all. Although I am a licensed clinician, I received the email via my website. Obviously, the most immediate need is to prevent children from being harmed. What is a good citizen to do in this situation?

Let’s start with the facts. In the absence of any knowledge about the individual, I take them at their word that they are tortured by thoughts of children. Research has shown that there are many people who have sexual urges regarding children who don’t act on that interest. Some may scoff at that notion and assume that everyone with these interests has already acted on them. In reality, most people have had some kind of sexual thoughts, urges, or fantasies that we have either managed or otherwise didn’t act on. Even the sender of the email didn’t want to act “against children.”

 

Something else is happening. Consider the findings of Sandy Wurtele, Dominique Simons, and Tasha Moreno who recruited 435 people to complete an online survey. From the introduction to that article:

 

Among men, 6% indicated some likelihood of having sex with a child if they were guaranteed they would not be caught or punished, as did 2% of women. Nine percent of males and 3% of females indicated some likelihood of viewing child pornography on the Internet. Overall, nearly 10% of males and 4% of females reported some likelihood of having sex with children or viewing child pornography.

 

Applied to the broader population, that number should concern anyone. As we have long known, the sexual abuse of children is not restricted to a few highly prolific, dangerous people who persist in hurting others. Rather, there are enough people with sexual thoughts about children to consider it a public health issue.

Returning to the email, my next question is who am I? Although I have expertise in this area, I have done no assessment or treatment of this individual. This cry for help does not contain enough information to make a report to any legal authority or child welfare agency. I am not an investigator. I could forward the email on to my local police, but there is no evidence that a crime has been committed, and all the evidence points to someone who is seeking to prevent a crime. The unfortunate reality is that our law enforcement organizations can’t keep up with the numbers of detectable crimes against children. And for all I knew, he might also suffer from pedophilic obsessive-compulsive disorder, in which one is afraid of being or becoming pedophilic.

What else do we know?

To start, I reside in the USA, where people cannot be charged with a crime or committed to an institution solely because of their thoughts and urges. Nonetheless, any reasonable person would want to take appropriate measures to prevent harm to children. That leads to questions about how we can all best respond to those who have sexual thoughts about children.

The first question is do we want this person to act on their interest or not? The answer to that question is clearly no.

That leads to the next question: What can we meaningfully do?

Research shows that simply trying to punish people has no effect on its own, and in some cases can make matters worse. However, the right treatment can work, as evidenced in large-scale meta-analyses. While treatment doesn’t work for everyone and many scientific questions remain, there’s much more evidence for treatment than there is for punishment. If society wants to prevent sex crimes against children, we need to get our priorities right.

From there, the next question becomes how should professionals behave with these clients?

Decades of psychotherapy research has pointed to the importance of maintaining a strong therapeutic relationship with clients. Therapists the world over know how important it is to engage clients and accept the person even if they don’t find aspects of them to be acceptable. As the saying goes, we need to love the sinner even as we hate the sin. Not every individual is a good fit for every therapist, and so some therapists understandably refer some potential clients to others.

How do professionals build the right relationship so that someone can trust them and get involved in treatment?

Entire books have been written on this topic, but for our purposes, attention to language is important. Please note that the email sender above calls himself a pedophile. On the one hand, this kind of honesty can be welcome, even refreshing. On the other hand, “pedophile” is a term almost always used in a hateful fashion. While diagnostically accurate (although current recommendations of the American Psychological and Psychiatric Association indicate that language such as “person diagnosed with a pedophilic disorder” would be optimal), it is difficult for the trained professional not to notice the tone of self-hatred in the email above. The individual describes himself as “sick” as well as a pedophile.

While it is unsurprising that people will use pejorative language to describe themselves, a central aspect of any therapy is to be careful with the use of these terms. The reason is simple: people who feel bad about who they are, who experience deep shame, who loathe themselves are less likely to benefit from treatment than those who can respect themselves even as they work to face the challenges in their life. Beyond this, there is an entire literature on labeling.

Recently, a colleague posted a YouTube video. In it, she accurately stated that people with pedophilic disorders are among the most reviled people in the world. For this reason, she uses the term “minor-attracted person.” By her own admission, she had not expressed this as effectively as she might in the video. The video was picked up on Twitter and immediately went viral with over 50,000 negative comments, primarily by people who had not watched the complete video or fully understood what she was saying.

Many, including myself, are ambivalent about the term “minor-attracted people.” My own thinking has to do with the vagueness of the language. The “Twitterverse” felt that it “normalizes” sexual interest in children when in fact its intention is the opposite. To listen to these individuals, the common message is, “It’s bad enough that we have these thoughts and urges that we don’t want. Please, we need help and understanding to prevent abuse.” Entire self-help networks have come into being because so few people are willing to provide treatment.

Many people with a sexual attraction to children have said that they prefer the term minor-attracted person as they work to prevent abuse. Everyone’s opinion will vary. Mine is that I don’t really care what’s in a name if we have a shared goal of preventing child abuse. I don’t need labels to describe people, tell the truth, or help people to take responsibility for their lives. Steering away from shaming language is not the same thing as enabling or normalizing. Hopefully, we can call each other by name and focus on the task of preventing sexual offenses. Public shaming and hatred of these people will only send them further underground and make matters worse.

In the classic parable of the Good Samaritan, a traveler (presumed to be Jewish) is beaten and left for dead. The Samaritan (whose people were sworn enemies of the Jews) stopped to help him. This was all in accordance with the Great Commandment. Within my own experience, I once watched firefighters risk their lives to put out a burning building. Their primary intention was public safety. They put the fire out first and only asked questions later.

In my view, both anecdotes illustrate the efforts of our colleagues who are involved in helping people not to act on their interests and urges towards children. They all deserve our thanks. In the moment someone is intervening to stop harm to children, does it really matter all that much what language they use as long as they are within the bounds of the law and their codes of ethics?

We live in a time when it is fashionable to call others we don’t like “groomers” and “pedophiles.” Too often, these insults obfuscate the realities of actual child abuse and serve to make people less informed instead of more. While society debates topics such as elementary school education and the rights and welfare of those in the LGBTQ communities, we should also support those professionals who are actually doing the work of abuse prevention.