The Bangor Daily News

May 17, 2013

By Erin Rhoda, Editorial Page Editor

Dear First Lady Michelle Obama,

I am sitting at my desk in Bangor, Maine, trying to find words that will carry weight for you. This is as good a time as there will ever be to change how the military responds to sexual assault. You do not have the executive authority to demand changes in the U.S. Armed Forces. But you have the ear of your husband, and you have shown you understand the need with your initiative Joining Forces.

It’s good the president is outraged about the recent report from the Pentagon that an estimated 26,000 people in the armed forces were sexually assaulted last year, an increase from 19,000 in 2010. It’s good he’s told the generals to address the problem. At least our country’s top officials are no longer refuting or downplaying the military’s troubles.

There’s something else he can do. Focusing on prevention and the venue for judicial proceedings is important, but he shouldn’t forget the thousands of male and female veterans, from World War II through the Iraq and Afghanistan wars, who have already suffered the degradation of sexual assault. Part of their healing will come from knowing that their country, for which they signed over their lives, will support them as they deal with post-traumatic stress disorder and other diagnoses.

Your husband should direct the Department of Veterans Affairs to relax standards currently required to determine disability compensation for veterans with mental health conditions related to sexual trauma. Sexual assault survivors should not have to meet the unreasonable burden of proving that a sexual assault occurred, such as by having the perpetrator convicted at a military trial. Most survivors do not report, and of those who do, few see a conviction. Yet they suffer. If a health professional diagnoses their mental health condition as being related to military sexual trauma and consistent with the circumstances of service, that should be enough to warrant disability benefits.

There is a bill with significant bipartisan support currently making its way through Congress called the Ruth Moore Act, sponsored by Maine Rep. Chellie Pingree, that would make this change, as it was made for veterans with PTSD a couple years ago. The House is scheduled to vote on it Monday, and the Senate will take up the matter later. But your husband doesn’t have to wait for Congress. He could issue the order on his own. It could take effect immediately.

Ruth Moore is from Milbridge, a town of about 1,300, located in Washington County where the Narraguagus River meets the Atlantic Ocean. More than 25 years ago, she was sexually assaulted once by her immediate supervisor in the Navy when she was stationed in the Azores and again in retaliation when she tried to get help. She tried to commit suicide. Her superiors denied the rapes happened, and her attacker was not punished.

The struggle continued. It was difficult then, as it can be difficult now, for veterans to get the disability benefits they are due. Moore was discharged with a mental health diagnosis, and her first applications for disability benefits were denied. She fought for years to get the benefits she knew, and eventually the military came to understand, were hers.

I talked to Pingree this week, and she reiterated a point she has been making for several years: “The fact is, we say to people who serve in the military: ‘You serve in the military, and we will take care of you.’ … It’s our job to say, ‘We’ll help you put your life back together.’”

Over the last six weeks, I have been taking a class to learn how to become an advocate with an organization in Bangor called Rape Response Services. Advocates may accompany sexual assault victims through their stay at a hospital. Their role is to support victims and provide them with options. On Tuesday, I had my last class.

After 40 hours of listening to other advocates, police, nurses, doctors and legal professionals share their knowledge of how to assist sexual assault survivors, I better understand just how important it is for victims to know their communities will help them through their pain and let them choose the route most fitting for their individual healing process.

There are many things I still don’t know. I don’t really understand why perpetrators feel they need to exert their power over another human being in such a horrific way. I don’t fully understand what it takes to heal after abuse. What about the woman I learned of who had her skull broken before being raped? The children who were molested by their mother? The woman who depended on her rapist husband because she had a disability and used a wheelchair? Recovering takes such strength.

What I did learn: So many people are working every day to both prevent sexual assault and make a difference in the lives of victims. The president wants to be, I believe, and should become, one of them. I tell this to you because Pingree and Sen. Jon Tester, D-Mont., have already asked your husband to take immediate steps. A little more reminding might be all it takes.

The Bangor Daily News

May 15, 2013

By Natalie Feulner, Special to the BDN

Substance abuse and mental health issues are often linked, underlying the fact that good health requires people to take care of both their physical and emotional needs, according to Angela Fileccia, a licensed clinical social worker with Summer Street Health Center in Bangor.

With one session left to go in our advocate training, my class of Rape Response Services trainees delved into the issue of mental health and how it affects our response to a trauma. It’s an unfortunate situation we’re likely to face: Not only are people with mental health issues more likely to be victimized, Maine’s per capita substance abuse rate is higher than the national average, Fileccia said.

The majority of recipients of mental health and substance abuse services in Maine have experienced either sexual or physical abuse, according to study materials provided by the Maine Coalition to End Sexual Assault. In fact, a study by the Maine Trauma Advisory Group in 1997 showed that 70-80 percent of people diagnosed with mental illness who have been treated in psychiatric facilities have a history of sexual trauma, physical abuse or both.

Often times our perceptions of mental health and substance abuse come from our experiences. My classmates share a range of connections to addiction and mental health disorders, some from childhood, others from professional experiences. Fileccia made it clear though that even if we didn’t directly experience mental health issues, we all have experienced stress in varying degrees.

That stress serves a purpose. In our “caveman days,” Fileccia said, the limbic system in our brain, which controls stress reactions, warned us when we were in danger.

Nowadays, however, that same limbic system is set to trigger during much different circumstances, such as dealing with a traffic jam. In more extreme situations, the limbic system reacts to trauma such as sexual assault. But the response is generally the same in both scenarios: We are programmed to fight, flee or freeze.

Memories are stored in two ways — as facts and realities or as interpretations and assumptions. Such interpretations could include thoughts similar to, “the man who raped me had black hair, so all men with black hair are dangerous.” It’s not a rational thought but is entirely reasonable in the mind of someone who has been violated.

In addition, most of us are more apt to remember negative memories rather than positive ones. It’s a survival mechanism that ensures we learn from past experiences.

Unfortunately, this means many victims will store the memory of an assault in a way that blames themselves. Maybe she thinks she shouldn’t have worn a short skirt; maybe he feels he should have had less to drink.

But no matter the memory interpretation, victims should never blame themselves. As it has been reported here in the BDN and taught time and time again in my class, the victim is never at fault for the crime.

These self-blaming expressions about what the victim feels he or she could or should have done differently to prevent the assault are what Fileccia called “automatic negative thoughts.” We as advocates should listen to these but not validate them. Instead, we may want to offer counter statements or initiate a conversation about how to approach the situation differently.

We have to, as always, make sure we leave our own baggage at the door as well. We must leave behind stereotypes, stigmas and disregard feelings of disbelief. We should think about the symptoms we are seeing, rather than trying to diagnose a victim or label him or her with a specific illness.

Symptoms of mental health issues and trauma look very similar. They can include an increase or decrease in sleep or appetite, irritability, a lack of concentration or motivation, an increase in distracting activities or a loss of interest in things once enjoyed. Physical symptoms can include but may not be limited to: shortness of breath, a racing heart, muscle tension or aches in the stomach or head.

In addition to the emotional and physical symptoms, many victims, both those with mental health issues and those without, will often question their reaction to the crime as it is occurring. Whatever the response, this, too, is controlled by the ever-powerful limbic system.

None of the common reactions — fight, flight or freeze — is a better choice than the other. In fact, freezing is not only more common than we think, but in some situations it may be the safest option.

So what do we tell someone who questions why they didn’t fight back?

Simple. “Your brain is trying to save your life,” Fileccia said.

Natalie Feulner is the BDN’s newsroom administrator.

The Bangor Daily News

May 10, 2013

By Erin Rhoda, Editorial Page Editor

Arthur Jette, 62, of Cambridge is a machinist by trade. He worked for a couple decades at Fayscott Co. in Dexter and served eight terms as a selectman in Garland. He now fills another, perhaps surprising, community role, working as the community relations coordinator of Womancare. The organization based in Dover-Foxcroft serves male and female victims of domestic violence.

Maine needs more male advocates. By speaking out, they set an example for others to follow. They show abuse is not a women’s issue but a societal one. Jette has seen the worst result of abuse, which is why he also serves as the volunteer leader of the Maine chapter of Parents of Murdered Children.

He has a big goal: “The battle is to change the hearts and minds,” he said during my recent training for people studying to become advocates with Rape Response Services in Bangor. Abuse is far more than physical violence. It can start with demeaning comments, emotional put-downs, coercion or isolating someone. He said to think of the continuum of abuse as measured by a 6-inch ruler. Probably about 5 of the 6 inches represent legal behavior. It’s up to all who see or hear those actions to recognize and stop them.

We spoke more afterward about what cultural change entails. He said, “There’s not any good way to try to talk about ending abuse without saying that it has to start with somebody, and so what I hope is that men will get to a point where, rather than just seeing themselves as having to use physical strength to be the protectors of the ones they love, they would be willing to step out and be willing to use the emotional strength, to be willing to stop the behavior that leads up to the violence.”

It’s a personal issue. On Dec. 3, 1999, he was working at Fayscott when his wife, Deb, called. She was so upset that office personnel said they couldn’t understand what she was saying. She told him her daughter, Cassie Cunningham, had just lost her 21-month-old son, Treven Cunningham, who was being watched by her best friend, Mindy Gould, 20, of Dexter.

Treven and Mindy were each shot once in the head. A few days before the murders, Cassie had helped Mindy obtain a protection order against her ex-boyfriend, Jeffrey Cookson, of Guilford. A jury convicted him of the double murders in December 2001. He is currently serving two consecutive life sentences.

Cassie, with Treven Cunningham, had lived with her mother and Jette at that time. Jette said the toddler had loved being involved with whatever the family was doing, even if it was bringing in firewood. Jette said he used to handpick tiny pieces for him to carry.

“I just think of what could have been,” he said. “Even the short time he lived, I know he changed us. He showed me how to love. I give him credit for that.”

The killings of Mindy and Treven were paralyzing, he said, describing that time as “a nightmare that you can’t wake up from.” Jette and family members started attending support meetings with the Parents of Murdered Children, which gathers at MaineGeneral Medical Center in Augusta at noon on the last Sunday of every month.

“The healing comes from being able not to suppress what you’re feeling but to be able to share it with someone else, to be able to speak open and honestly with someone else,” he said, adding that it helped to connect with people who had also experienced tragedies and who were willing to listen and accept the emotions that were shared.

Womancare had helped Mindy before her death, so Jette and family members volunteered in small ways for the organization and attended vigils. Then, Jette decided to take the 40-hour training to become a volunteer advocate. And when a position opened up in May 2008, he said he saw it as an opportunity. He was the first male Womancare hired.

“I have so much desire to do so much to eliminate abuse from the lives of people who are living in it that I look for excuses not to take time off,” he said.

He continues to talk about the need for everyone to treat others respectfully and stop small behaviors and derogatory comments that contribute to the larger culture of violence. Men have a large role to play.

“When I think about what it would be like to have a society where men would be willing to be straight up and honest about not wanting to see their boys have to use examples of strength as the only way they could prove they were men, I think that alone would make a big difference,” he said.

The Bangor Daily News

May 7, 2013

By Natalie Feulner, Special to the BDN 

Bangor Nurse Honored for Sexual Assault Forensic Examiner Work

May 2, 2013

Rape Response Services was so pleased to be able to honor and thank Michelle Markie, RN of St. Joseph’s Hospital for her work as a sexual assualt forensic examiner.  Michelle is exceptionally caring and compassionate and is committed to a victim centered approach.  She willingly shares her knowledge and expertise with the community and is an active member of the Penobscot County Sexual Assault Response Team.  Because of her efforts, Michelle not only supports victims/survivors but she is working to prevent sexual violence from happening in the first place.

Michelle Markie with RRS staff

Michelle Markie with St. Joseph’s Hospital staff

Click here to watch the story.

Thank you Michelle for all you do!

The Bangor Daily News

April 26, 2013

By Erin Rhoda, Editorial Page Editor

If you were sexually assaulted, who would you tell? Now imagine you are a child or adolescent facing that question, and the person abusing you is your mother, father, grandmother or grandfather.

A Robbinstown mother testified before a legislative committee in February that her daughter endured seven years of rape, abuse and incest by her biological father. It happened on the weekends he was supposed to be taking care of her, as the couple had separated. The mother said she missed her daughter’s silent cries for help, such as her wanting to be alone after spending time with him, a change in eating habits and eventually fainting spells.

“Maybe she could have found the words through education and school to have opened up to myself or another adult or friends,” she said.

The mother’s experience led her to urge lawmakers to support a bill, LD 95, sponsored by Rep. Joyce Maker, R-Calais, that would create a task force to study the issue of child abuse in Maine. It could result in recommendations for age-appropriate curricula and ways to increase teacher, student and parent awareness.

Educating Maine schoolchildren about appropriate and inappropriate touches, and how to respond, may not prevent abuse. But it will create active bystanders and may make it easier for abused children to confide in someone they trust. As I am learning in my 40-hour class to become an advocate with Rape Response Services in Bangor, there are many reasons why both adults and children stay silent.

They may be told the abuse is their fault or that bad things will happen to their family if they talk. They may think no one will believe them. Our training manual contains explanations from child victims, in their own words:

“He was too much bigger to me, so I didn’t say nothing,” said a 4-year-old.

“He said if I told my mother, he would kill her and eat her, and he said if I told anyone else, he would just kill me,” said an 8-year-old.

“I was told that I’d be put in a foster home if I said anything,” said an 11 year old.

Some people might think it’s the role of family members to talk with their children. It is, but what if they are the ones committing the crime? Children are sexually assaulted by strangers, but more often they are abused by people they know, whether acquaintances, family members or older children.

Many Maine schools discuss abuse. Or they request a service center with the Maine Coalition Against Sexual Assault to provide free sexual violence prevention education. But the efforts aren’t uniform across Maine schools and can be improved. LD 95, to create the task force, is proposed as an emergency measure, so it will take effect immediately upon passage, which is likely.

“This is an emergency,” Maker, the bill’s sponsor, said. If Maine doesn’t do something now, “that’s one more child who’s being abused as we speak.”

There are a number of age-appropriate ways to talk to children about abuse. Educators with MECASA, for example, educate students about personal body safety, which can include talking about the difference between “good touch,” “hurtful touch” and “confusing touch.” Ultimately, youth should understand the following:

• Their body belongs to them.

• Touches are supposed to feel good.

• Touches in private areas are only to keep them clean and healthy.

• Touches are never secrets.

• If they feel hurt or scared, they should tell someone they trust.

• It’s never too late to tell someone.

• They should keep telling until they get the help they need.

It’s difficult to talk about abuse, but perhaps that’s one reason why it’s remained such a problem. One study published in 2003 found that about one in three girls and one in seven boys will be sexually abused at some point in their childhood. We may hear more about the high-profile cases involving offenders who are public figures, but, of course, child abuse happens in every community. It will take a community reaction to reduce the rates of victimization, and talking to children is a good place to start.

The Bangor Daily News

April 23, 2013

By Natalie Feulner, Special to the BDN

Last week, my class of Rape Response Services’ advocates-in-training spent our three-hour training session at St. Joseph’s Hospital with Sexual Assault Forensic Examiner and Registered Nurse Michelle Markie. Markie is one of two certified SAFE nurses employed at St. Joseph’s, a certification requiring a 40-hour class, hours of observation, ongoing education and practice administering rape kits.

The kits contain equipment nurses can use to collect DNA evidence, take photos of injuries and perform overall health exams of sexual assault patients. Information obtained can be used in court cases to corroborate a victim’s story.

We were there to learn about the various components of rape kits and about the overall treatment of sexual assault victims. I also walked away from the class confident that the hospital doesn’t have to be a frightening place for victims, so long as he or she remains in control, is supported by an advocate and feels believed by members of law enforcement.

Markie explained that when a sexual assault victim is brought to or arrives at the hospital, that person is treated as a trauma patient and immediately taken to a private room. Shortly after, nurses will notify Rape Response Services, which will send someone to support the victim through the next few hours and beyond.

The advocate is there to fill an emotional role, Markie said, while nurses are there to treat medical needs. Law enforcement is present, if the victim wishes, to take a report and investigate the crime.

“It’s a team approach — a nurse, the advocate and police,” she said.

The exam takes anywhere from three to six hours to complete, and once the kit is opened, SAFE nurses are unable to leave it for any reason — to maintain what’s called “chain of custody” of the evidence. That means other tasks, such as getting water for the victim or talking to family, falls to the advocate. Kits are free for the victim, as they are paid for through the legislatively mandated Victims’ Compensation Program.

Markie estimated that about 90 percent of the women she treats after a sexual assault have no injuries, and close to 98 percent of children do not have injuries. It’s a fact she attributes to the anatomy of the female body. Some people may think that if victims don’t show signs of physical injury, the incident wasn’t severe, but that’s not true.

Nurses gives victims complete control when it comes to declining or accepting portions of the rape kit. If someone doesn’t want their nails clipped for evidence collection, for example, they can have them swabbed. If another person is OK with everything but an internal exam, that’s OK, too.

It’s a way for the victim to feel even the smallest amount of control after experiencing such a loss of power during a sexual crime.

Markie added that she does not give speculum exams to women or teens who have never undergone one for routine health purposes. She believes such an exam would only traumatize the victim more and cause her to be reminded that the first time she received such an exam was the night she came to the hospital because she was raped.

Once the kit is completed to the victim’s satisfaction, it is sealed with red evidence tape and taken one of two places. If a report was made, the police station where the incident occurred will take the kit from the hospital and send it to Augusta for evidence testing. If it is not being submitted right away, the kit stays at the Bangor Police Station for 90 days or until the victim comes forward with a report.

That 90-day waiting period is crucial for people to know about, Markie said. That’s because more victims would probably come forward if they knew they didn’t have to make a report or knew they had time to think about doing so.

The fear of reporting to law enforcement is evident in many cases. Some victims feel they won’t be believed by officers, while others are afraid their information will become public knowledge somehow. Some work with law enforcement for a while and then decide they don’t want to pursue charges any longer.

Still, more people are arriving at the hospital year after year to seek treatment and request kits. According to Markie, 35 victims were treated at St. Joseph’s last year, an increase from 2005 when she started and there were fewer than 10.

However, the increase in exams doesn’t necessarily match the number of nurses in Maine who are certified to administer rape kits. The state has a shortage of SAFE nurses, less than 30, Markie estimates, many of whom are clustered around the state’s service centers. It’s a problem Markie hopes takes a shift in the near future, but she said she also recognizes that the role is not for everyone.

Even just hearing a few stories of victims she treated had my stomach churning. But I had to remind myself that those feelings of anger and empathy are exactly why I and everyone in our community should take time to learn about sexual violence and what can be and is being done to prevent and treat it.

Natalie Feulner of Bangor is the BDN newsroom administrator.

The Bangor Daily News

April 19, 2013

By Erin Rhoda, Editorial Page Editor

In psychology, a term called “collective trauma” refers to the effect felt by many people in the aftermath of a tragedy. The pain of collective trauma — sustained after events such as President John F. Kennedy’s assassination, Sept. 11, the shootings in Newtown, Conn., and the bombings and manhunt in Boston this week — can influence cultural norms and drive mass action. A society is affected, and a society heals together.

Communities begin to heal when the people within them develop secure connections with family, friends and loved ones and address the loss and trauma symptoms. Healing is aided by the normalization of trauma reactions — basically, understanding that fear, sadness, anxiety and anger are normal responses to abnormal situations. No one responds in the same way to a traumatic event, and reactions can be complex.

With Friday’s violent manhunt for the Boston Marathon bombers ending a week of one tragedy after another, many people may experience some level of emotional shock.

They don’t have to experience an act of terrorism directly to have a heightened response. In a study reported in the Journal of Anxiety Disorders in 2007, researchers examined the effect on children and their mothers of television coverage of the Sept. 11 bombing at the World Trade Center in New York City. Though the study subjects were not present at the disaster, 5.4 percent of the children and 1.2 percent of the mothers had post-traumatic stress disorder symptoms from seeing it on TV.

I have been learning about the effects of horrifying, overwhelming experiences as I take a 40-hour course to become an advocate with Rape Response Services in Bangor. Experts used to think PTSD affected only soldiers, and, while traumatic disorders are common among people who experience combat, it was largely the women’s movement in the 1970s that established the category of post-traumatic stress disorders in the American Psychiatric Association’s Diagnostic and Statistical Manual in 1980. From the movement emerged greater awareness of the effects of rape, domestic violence and child abuse.

According to the PTSD Alliance, the estimated risk for developing PTSD after different types of trauma is: rape, 49 percent; severe physical assault, 32 percent; sexual assault other than rape, 24 percent; serious accident or injury, 17 percent; shooting or stabbing, 15 percent; sudden unexpected death of a family member or friend, 14 percent; a child’s life-threatening illness, 10 percent; witnessing a killing or serious injury, 7 percent; and natural disaster, 4 percent. Acts of terrorism are rare in the United States but cut deep and put thousands of people at risk for PTSD.

Reactions to trauma are normal, healthy and help people survive. With a typical stress response, people might have difficulty concentrating; they might feel guilty, shocked, helpless, anxious, fearful or irritable and have an increased “startle” response and loss of interest in usual activities. They might withdraw and want to avoid contact with the outside world. Acute stress disorder is more serious and long-lasting and can also involve dissociation — where people experience changes in their sense of self, time and memory — along with severe anxiety, hypervigilance and flashbacks. PTSD is very similar to acute stress disorder but lasts longer and interferes with regular activities.

People shouldn’t be afraid to seek counseling, said Ann Hartman, a licensed clinical social worker with a private practice in Bangor. “It’s OK to get help. It’s actually a strong thing,” she said. A counselor can help patients understand what’s happening to them, identify any triggers and ensure they are taking care of themselves.

There are different therapies and paths to wellness. Hartman said it’s important for people to stay connected to others, as, “Trauma can be a pretty isolating experience.” And some people find mindfulness practices — like meditation or yoga — helpful. It can also be comforting to people to do something positive, whether it’s giving a donation or volunteering at a local charity, “to feel connected, like they’re trying to make something good out of something so bad,” Hartman said. “What we’re talking about is trying to make people feel empowered again.”

Empowered again. It’s possible, especially when people come together, to go on together.

Maine’s statewide crisis number is 1-888-568-1112.

The Bangor Daily News

April 17, 2013

By Tamar Mathieu, Special to the BDN

The Bangor Daily News

April 16, 2013

By Natalie Feulner, Special to the BDN