Protective Factors: A “New” Discovery?

Readers may be interested in de Vries Robbé, Mann, Maruna, and Thornton’s (2014) recent article, "An exploration of protective factors supporting desistance from sexual offending," currently published in the online first section of Sexual Abuse: A Journal Research and Treatment (SAJRT). This is actually one of a series of articles written by de Vries Robbé and various colleagues, but possibly the first in the “series” that specifically focuses on the role of protective factors in work with sexual offenders. In fact, Thornton (one of de Vries Robbé’s co-authors in this case) published an article last year (2013) discussing the implications of a model that recognizes both risk and protective factors in the treatment of adult sexual offenders, asking how treatment tasks might be revised “in light of this new knowledge” (p. 62). Similarly, focusing on the idea of “new knowledge,” Worling and Langton (2014) write that research into protective factors for sexually abusive youth is only in its earliest stages. Actually, Spice and colleagues (2012) might have been the first to point to the complete lack of research into the subject of protective factors, at least with respect to sexually abusive youth, and van der Put and Asscher (2014) are among the first to correct this situation in their study, examining the nature and effect of protective factors in the behavior of sexually abusive youth.

 

The addition of a literature that addresses and incorporates ideas about protective factors, and not just risk factors, in sexual offender assessment is welcome, a topic area to be further addressed in a forthcoming special theme issue of SAJRT. But, it seems important to add that although relatively new to sexual offender risk assessment, the idea is not especially new (and really not even that new to sexual offender assessment and treatment, at least not for those practitioners who work with sexually abusive youth). Although it may be accurate to say our empirical and theoretical examination of protective factors is new, the existence and function of protective factors in assessing risk is certainly not “new knowledge,” as Thornton described it. Rich (2003) wrote about protective factors over a decade ago, and in additional detail in 2009 and 2011. Furthermore, protective factors have been built into several juvenile risk assessment instruments since around 2001 with the introduction of the AIM assessment protocol, used in the UK, and further developed in the AIM2, revised in 2007. Similarly, the SAVRY, a general (non-sexual) adolescent risk instrument in use for over a decade, has included a table of protective factors since the instrument was released in 2002. The J-RAT, a juvenile sexual risk instrument in use since about 2000, has included a protective factor scales since 2012, as does the MEGA, a more recently introduced juvenile sexual risk instrument. Although neither are widely used, Bremer's Protective Factors Scale (1998, 2006) and Gilgun's (1999) Clinical Assessment Package for Client Risk and Strengths offer additional examples of instruments built around the presence of and designed to assess protective factors, both of which have been around for a number of years. In the world of adult sexual risk assessment, the ARMIDILO-S, designed for use in the assessment of intellectually disabled adults, has included an assessment of protective factors since its inception in 2004, as does the currently in-development youth version of the instrument.

 

So, what point is being made here? Just that the recent and happily expanding attention being paid to protective factors in our literature neither represents new knowledge nor recent innovation in the field of risk assessment or treatment. Jessor and colleagues discussed protective factors in understanding troubled adolescent behavior back in 1995, and in 2003 Rutter wrote of the obvious need to pay attention to protective factors, as well as risk factors. Going back a few years earlier still, in their exploration of resiliency among troubled and high-risk children Werner and Smith wrote about protective factors and relationships in 1992. This protective factors, or strength-based, approach to assessment and treatment recognizes that there is more to risk than risk alone, and more to treatment than simply containing risk. Instead, it tells us that we must recognize and assess factors that not only protect against risk, but also increase the likelihood of desistance from continued problem behaviors. It is gratifying to see increasing attention being paid to the presence and nature of protective factors and the mechanisms by which they harness or increase resiliency, but it is also oddly disturbing that we seem to have only recently "discovered" ideas that have actually been there all along, even within our own field. These are not new ideas; we just seem to have not "noticed" them before, or been too busy looking at other things to notice them, or perhaps simply unaware of the larger mental health field and the field of human development around us. It is possible that this has something to do with the formerly very narrow field of vision that has permeated and perhaps defined sexual offender treatment, and especially the treatment of adult sexual offenders.

 

An increasing awareness of protective factors, and an increasing prominence in our research, is welcome. However, protective factors have been there all along; they have already been “discovered.” The current task involves, not discovery, but better understanding protective factors, empirically and in clinical practice, including not only what we should count as protective factors, but also how they work and, importantly, how they interact with one another and how they interact with risk factors. It is this focus that most represents the area of new knowledge – not the discovery of protective factors, but instead how they work, and under what circumstances.

 

Phil Rich, EdD., LICSW

 

References

Bremer, J. F. (1998).  Challenges in the assessment and treatment of sexually abusive adolescents.  The Irish Journal of Psychology, 19, 82-92.   doi: 10.1080/03033910.1998.10558172

Bremer, J. (2006). Protective Factors Scale: Determining the level of intervention for youth with harmful sexual behavior. In D. S. Prescott (Ed.). Risk assessment of youth who have sexually abused (pp 195-221). Oklahoma City, OK: Wood & Barnes.

de Vries Robbé, M., Mann, R. E., Maruna, S., & Thornton, D. (2014). An exploration of protective factors supporting desistance from sexual offending. Sexual Abuse: A Journal of Research and Treatment. Advance online publication. doi: 10.1177/1079063214547582

Gilgun, J. F. (1999). CASPARS: Clinical assessment instruments that measure strengths and weaknesses in children and families. In M. C. Calder (Ed.), Working with young people who sexually abuse: New pieces of the jigsaw puzzle (pp. 50-58). Dorset, England: Russell House Publishing.

Jessor, R., Van Den Bos, J., Vanderryn, J., Costa, F. M., & Turbin, M. S. (1995).Protective factors in adolescent problem behavior: Moderator effects and developmental change. Developmental Psychology, 31,923-933.         

Rich, P. (2003). Understanding juvenile sexual offenders: Assessment, treatment, and rehabilitation. Hoboken, NJ: John Wiley & Sons.

Rich. P. (2009). Juvenile sexual offenders: A comprehensive guide to risk evaluation. Hoboken, NJ: John Wiley & Sons.

Rich, P. (2011). Understanding juvenile sexual offenders: Assessment, treatment, and rehabilitation (2nd. ed.). Hoboken, NJ: John Wiley & Sons.

Rutter, M. (2003). Crucial paths from risk to causal mechanisms. In B. B. Lahey, T. E. Moffitt, & A. Caspi (Eds.) Causes of conduct disorder and juvenile delinquency (pp. 3-24): Guilford Press.

The Community and the “Cure”

In a recent television interview, a talk-show host asked boxer Mike Tyson why people should take his opinions seriously when he is a “rapist.” This referred to a crime that Tyson committed over two decades ago. Tyson’s response was swift and characteristic of his career; he insulted the interviewer and challenged him to a fight. Although the situation was unfortunately and entirely unnecessary, it demonstrated what research has found: people change, and violence and aggression are more likely to persist than sexual abuse. Mike Tyson may have persisted in many undesirable behaviors, but he has apparently desisted from further sexual abuse. Tyson objected to the label “rapist,” and perhaps we should as well.

In the interest of accurate language, Mike Tyson is a person who has been violent towards others in and out of the boxing ring. Sexual abuse is an area where, as Bill Marshall (personal communication, September 11, 2014) recently observed, our labels stick like glue. It is fascinating that the interviewer used this particular label rather than asking, “Why should people take your opinions seriously when you’ve bitten off parts of your opponents’ ears and assaulted strangers on the side of the highway?” Perhaps part of the answer lays in public ignorance about how sexual re-offense does – and more importantly – does not happen.

Relevant to this is a study (in press) that merits close attention. Karl Hanson, Andrew Harris, Leslie Helmus, and David Thornton studied 7,470 sexual offenders from 21 samples and found that:

The risk of sexual recidivism was highest during the first few years after release, and decreased substantially the longer individuals remained sex offence-free in the community. This pattern was particularly strong for the high risk sexual offenders (defined by Static-99R scores). Whereas the 5 year sexual recidivism rate for high risk sex offenders was 22% from the time of release, this rate decreased to 4.2% for the offenders in the same static risk category who remained offence-free in the community for 10 years. The recidivism rates of the low risk offenders were consistently low (1% to 5%) for all time periods. The results suggest that offence history is a valid, but time dependent, indicator of the propensity to sexually reoffend.

Certainly, official records of re-offense underestimate the true rate of sexual crimes. However, the overall trends in this study reflect what we already know from numerous other studies around the globe. Most sexual offenders are not known to re-offend, and only a small minority is at truly high risk. This presents many opportunities for reconsidering our current approaches to management, including the use of strategies that reduce risk, protect communities, and help assist those affected by sexual abuse that are more efficient and cost-effective than the many ineffective strategies in place today (e.g., residence restrictions).

These findings should prompt all professionals and the lay public to reflect on their beliefs about people who sexually abuse. Until recently, Colorado statutes stated that, “there is no cure for sex offending,” as though it were a disease instead of a preventable behavior. Likewise, by the time someone reads this blog, it is highly likely that they have heard the expression “once a sex offender always a sex offender.” Although even one sex crime is one too many, this study shows that short-term and intensive strategies for preventing sexual re-offense (such as high-quality treatment and sensible community supervision) are more likely to be effective than long-term, passive, and as-yet unproven methods such as Internet registries. 

Further, this study shows the opposite side of a familiar coin. Prisons and other forms of punishment do not actually reduce crime (Smith, Goggin, & Gendreau, 2002). However, time spent successfully in the community is associated with desistance from crime. Recent research has highlighted the success of many community-based programs and their emphasis on developing a balanced, self-determined lifestyle (Wilson et al, 2009). This study points to the importance of using treatment and supervision to expedite desistance-related processes (such as stability, staying occupied, having prosocial supports, and implementing plans for self-improvement) rather than simply as tools for monitoring behavior.

Human beings naturally default to detecting and managing risks in the short term.  Current research into assessment methods has helped us become even more adept at understanding and categorizing these risks. Developing effective means to ensure long-term public safety has taken longer. The most effective means for managing risks has presented far more challenges in our research and practice as well as the way we think about individual cases (such as Mike Tyson). Hanson and his colleagues’ findings point to the next steps we can take in supplementing our knowledge of risk with skillful reintegration.

As a final note, it is again important to note that not every crime is detected. However, it is noteworthy that these findings extend across all risk categories in a large sample and speak to the importance of allocating our most intensive resources to those who need them the most.

David S. Prescott, LICSW

References

Hanson, R.K., Harris, A.J.R., Helmus, L., & Thornton, D. (in press). High risk sex offenders may not be high risk forever. Journal of Interpersonal Violence.

Smith, P., Goggin, C., & Gendreau, P. (2002). The effects of prison sentences and intermediate sanctions on recidivism: General effects and individual differences.Research Report 2002-01. Ottawa, ON: Solicitor General Canada.

Wilson, R. J., Cortoni, F., Picheca, J. E., Stirpe, T. S., & Nunes, K. (2009). Community-based sexual offender maintenance treatment programming: An evaluation. (Research Report R-188). Ottawa, ON: Correctional Service of Canada.

Peak Week: The End

No matter what happens on the 27th, I'm a winner.



No trophy or top five placement could top the sense of accomplishment I'm going to feel after stepping on stage. Not only accomplishment, but knowing that I've inspired at least one person.



And I know I have because at least once a week at my gym I get to see Tammy, and she tells me every time how proud she is of me and what an inspiration

Exploring the Emotions Behind Genital Cutting

62 years ago, in 1952, Wilhelm Reich said, “Take that poor penis. Take a knife—right? And start cutting. And everybody says, “It doesn’t hurt.” Everybody says, “No, it doesn’t hurt.” Get it? That’s an excuse, of course, a subterfuge. They say that the sheaths of the nerve are not yet developed. Therefore, the sensation in the nerves is not yet developed. Therefore, the child doesn’t feel a thing. Now, that’s murder! Circumcision is one of the worst treatments of children. And what happens to them? You just look at them. They can’t talk to you. They just cry. What they do is shrink. They contract, get away into the inside, away from that ugly world.”

Reich lived from 1897 to 1957. He was an Austrian physician who was a pioneering psychoanalyst and considered one of Freud’s best students. However, over time, he became disappointed with the results that could be achieved with Freud’s method of free association. This prompted him to develop a very different framework for understanding people and emotions.

I am a board-certified psychiatrist and for more than 40 years have been using the unique and very effective treatment that Reich created. I also train psychologists and other psychiatrists to practice this therapy. It’s very different from any other treatment for emotional disorders that you may have heard of.  And even if you have heard of Wilhelm Reich, or have some knowledge of the therapy that he pioneered, his method of treatment is often misunderstood and, unfortunately, misrepresented. It makes use of a verbal interchange that’s different from other methods of psychotherapy. It seeks to make the patient aware of the particular manner in which they approach the world. Reich called it “character analysis.” The treatment also allows the release emotions, primarily sadness and anger, in a controlled way, in the safety of the therapist’s office.

Reich discovered that emotional traumas are not forgotten, even when they occur very early in life and remain out of conscious awareness. Physical pain is traumatic for everyone, but for an infant or young child, the shock to their system can be terrible. This is the reason why Reich, although Jewish, spoke out so vehemently against circumcision.

Just how it is that events from the distant past can be locked away somewhere in the body remains a mystery. Nevertheless, the traumas of childhood, if severe enough, are never forgotten. They stay stuck in us—in our “armor” as Reich called it—and exert their damaging effect throughout life. This fact, that the past is not forgotten, is virtually unknown. Early childhood traumas, not chemical imbalances, are the root cause of lifelong dissatisfaction and unhappiness, as well as many severe emotional disorders, including schizophrenia.

Now what is very interesting and remarkable (and in fact this still amazes me, as it did Reich) is, in the course of this therapy, patients may actually re-experience their earliest traumas. I have seen men re-live their circumcision, with all the pain and terror they suffered. In a few minutes I am going to play a clip of one of my patients speaking about his experience when he re-lived his circumcision during therapy. I had him filmed for this conference.  

But first, I am going to show you a clip of him on the therapy couch during the course of a typical session. This clip comes from a documentary film that was made some years ago. What you are going to see may be a bit shocking, but please know that Bob has always left every session much relieved and in fine shape.

As this clip showed, the past remains alive. Now as for circumcision, it is so extremely harmful because it occurs so early in life. The younger the child, the less are the defense mechanisms to deal with pain. As an adult, or even an older child, we have the sum of our intellect and our experiences to put shocking events in some context and perspective.

The next clip I am going to play shows Bob telling about re-living his circumcision. This was just filmed.

So now I want to turn to a different subject, and the topic of my talk, which is the unconscious cruelty that drives humans to circumcise newborns and children.

All of us here today understand that cutting the genitals of children is not just unnecessary—-but barbaric—-and there’s not a single, rational argument to support it. However, because there are so many sides to the issue, people can’t see circumcision for what it really is. They are confused because of the social and cultural factors, the demands of religion, the medical justifications—and so on. But I’d like to touch on one aspect that is almost never considered— the forces that drive people and institutions to support this practice.

Can any sense be made of what it is that impels people to brutally cut the genitals of defenseless newborns and young children, male and female alike? For the answer to this question I again look to the work of Wilhelm Reich. One of his most important contributions is his exposition of what he termed the “emotional plague.” It’s a very complex subject and I will try to do it a bit of justice in the next few minutes. But if any audience can grasp this concept, I think this one will.

Reich maintained that within our society, and in fact in all patriarchal societies, there are certain individuals that he called emotional plague characters. These people have very specific characteristics and ways of behaving. They are intelligent, extremely competent, aggressive, and endowed with a high energy level. And they are very good at getting themselves into positions of authority and power so they can tell others what to do for their own good.

Emotional plague characters, big and small, have existed throughout history. They are not just the Hitlers and Stalins, but also the petty tyrant school teachers who terrorizes the children in their class; the religious leaders, who mandate right and proper behavior; the supervisors everywhere that keep those under them in constant fear; the heads of organizations that put into effect policies that restrict personal freedom, and so on.

The emotional plague is not just confined to individuals but also becomes institutionalized. This can be seen in many of our law-making bodies that, more and more, dictate how we should live, again, for our own good.

The reasons behind this behavior are too complex to go into here, but what can be said is that plague characters, because of the particular way they were raised, are disturbed and very angry people. But they are unaware of their anger. They are not like the average neurotic who suffers quietly to themselves. In fact, they don’t suffer much at all because they act out their anger, which is unconscious, on the social scene. This is not something they choose to do. They are driven to act this way. And they really believe they are doing the right thing.

Seeing others who are lively, happy, and enjoying themselves creates in them not pleasure, as it would with a healthy person, but jealousy and resentment. These feelings are so intense that the only way they can stop them is by going out into the world and stopping people from having pleasure. This is what makes these individuals feel better.

What makes the emotional plague so effective, and so dangerous, is that their arguments are extremely well rationalized and always “partly right.” We can see with regard to circumcision how this “partly right” confuses: Maybe my boy should look like the other boys. Maybe, as a Jew, I should have my son circumcised. Maybe the doctors are right that my boy could get infections. It’s the partly right that confuses, and prevents us from seeing what’s right in front of our eyes.

Because the emotional plague hates pleasure in others, and seeks to stamp it out, children, who by their very nature are lively, happy people are a prime target. So is natural sexuality. Circumcision targets both children and natural sexuality.

So what can be done? Reich said the only way to combat the emotional plague is to expose it. This doesn’t mean pointing fingers and calling people “plague characters.” It means exposing the work of the plague to the truth. Consistently making people aware of the lies that allow this practice to continue.

Also, to keep our focus on educating the public and the upcoming generation of doctors and others who will re-shape existing policies. We have truth on our side, and the children of the future will be the beneficiaries of our efforts.

This lecture was presented at the 13th International Symposium on Genital Autonomy and Children’s Rights, held at the University of Colorado in Boulder on July 24-26, 2014. The conference provided a forum for discussion about the genital alteration of infants and children from religious, medical, human rights, and other perspectives. Speakers from around the world reported on the approaches they have taken, and the progress that has been made, for protecting male, female, and intersex children from medically unnecessary genital alteration.

Week 6/5

So, since going through this journey I've been getting a lot of questions from people. Messages, people asking me in person, every venue you can think of people have been trying to get my advice about health and fitness.

All I can suggest is to do the research and decide for yourself.

I can give you all the tools in the world, but over 50% of this stuff is an attitude.

I'm not on a diet.
This

The anonymity debate

This was not the blog I sat down to write, that’ll come in a couple of weeks. 

This blog was instead prompted by recent events and news on the evening of Monday 18th August 2014 in the UK. Last week Sir Cliff Richard’s house was searched by the police in regard to sexually inappropriate offences that took place in the 1970’s, while that may have been challenging for some to accept that was not the main furore; the police tipped of the BBC, who recorded the whole “raid” live, and did not inform Cliff (Daily Mail). Both sides are blaming the other and claiming that they themselves were not in the wrong (the independent). Reaction has condemned the Police and the BBC (Yorkshire post; Telegraph), and society (the independent); however, people came forward with allegations against Cliff [London evening Standard]. The whole event has left an uneasy feeling.

The ITV News (one of the main news broadcasters'in the UK) on 18th August 2014, commissioned a poll to look at public attitudes to anonymity for sexual abuse defendants prior to being deemed guilty by a court [ITV News],  which is a hotly debated issue raised a number of times in the press (Huffington Post;The Scotsman) and in parliament (House of Commons - Home Affairs - Fifth Report; the independent), as well as by defendants (ITV news). Part of the explanation for the argument for anonymity is because sexual abuse allegations are so stigmatic and tend to linger in the public mind set regardless of whether the defendant is found not guilty or not (i.e., “no smoke without fire”). The ITV poll found that 74% believed that people facing sexual abuse allegations should receive anonymity prior to a guilty verdict.

This debate is not a straightforward one, it is exceptionally complex one with a number of  interested as well as invested players; the aim of this blog is not to answer the question but to prompt debate and reflection. Some of the main arguments, as I can see them, are from;

Victim – Identifying there defendant gives credence to the victim in the sense that it recognises and validates their abuse claims; it shows them that the criminal justice system is taking them seriously and in doing so it helps them in their journey for justice. It progresses the fight for victims rights. However, outing the defendant can sometimes out the victim, especially if they are vulnerable (i.e., victims of child sexual abuse have anonymity in the UK and there have been cases where poor reporting has resulted in the victim’s identity being outed) and make them feel vulnerable, under pressure pre-trial.

Defendant –The identification of the defendant means that those others around them are aware of their offences, potentially stopping them going underground, making sure that they stick to their pre-trial arrangements, preventing them from reoffending and/or making sure that they do not approach the victim. In addition, other defendants get named in other offences, why should sexual abuse be any different? But sexual abuse has a massive social stigma attached that negatively impacts the defendant, regardless of guilt or the court’s decision, which can impact their current and future lives (i.e., jobs, family life, etc) (ITV news), affecting their mental health and (potentially) increasing their potential risk as well as dangerousness to themselves and/or others. Interestingly, we spend so much academic and professional time discussing community notification post release, forgetting that we notify the community and disclosure their information pre-trial.

Criminal Justice System - This one is most complex position as there is a requirement to protect the public balanced against upholding victims’ rights, defendant’s rights and the integrity of the case (i.e., not to negatively impact the outcome of the case in court or in getting to court through inappropriate procedural behaviour). In short, maintaining the “innocent until proven guilty” aspect of the criminal justice system regardless of related social, personal or professional attitudes. Sexual abuse cases generally fall within a punishment paradigm which means that the core tenants of the criminal justice system can be diametrically opposed, rather than work in tandem.

As I said at the beginning this is a complex issue with no straight forward answer, there are a lot of involved, interested and concerned parties. I for one am not suggesting any distinct course of action, but instead saying that the identification of sexual assault defendants pre-trial outcome has consequences on them, their families, their victims and the criminal justice system: if we are reframing the sexual abuse debate we should look at all angles of it, including this one, regardless of how it makes us feel.

 Kieran McCartan, PhD

Correcting Course: Have We Missed the Boat on our Clients’ Adverse Experiences?

A recent discussion on the ATSA listserv was worth following. It began with the simple question of what sorts of trauma-informed systems of care exist for adolescents who have sexually abused, and extended well beyond. One member basically asked why it is only now that the notion of trauma-informed care seems to be coming into vogue in our field. It is an excellent question with no clear answers for now. One member commented on how in the past many therapists noted that their clients seemed to excuse their abusive actions by claiming that they had themselves been abused. Clearly, a side effect of helping clients in the direction of becoming accountable for their behavior could be the therapist’s implicit or explicit minimizing of their past experiences. This ATSA member commented that while it can be necessary to help people move through defensive excuse-making into a more honest conversation, the original intent of holding clients accountable was never to dismiss the harm that had been done to them.

A case from the author’s experience is haunting and illustrative. In one agency that employs polygraph examinations, it was routine to polygraph clients on their disclosures of past victimization, apparently with the underlying assumption that their clients often sought to excuse their behaviors. While this use of polygraph could itself be the subject of many other discussions, an interesting situation arose when the therapist ordered a polygraph to verify the account of a client in treatment who claimed a lengthy history of sexual abuse as a child. He had received individual therapy for this over the course of a year. Upon failing the examination, the client said that in fact he had been lying to his therapist about this abuse all along. He went so far as to use uncouth language to assert that his treatment team were naïve and foolish for believing him.

Whatever the truth in the above client’s case (and setting aside other florid concerns about his functioning), one is still left with the question of whether other adverse, even traumatic, experiences in this client’s life contributed to his offenses and his behavior in treatment. What events in his background led him to believe that it was in his interest to interact with others this way? In other words, when we ask about abuse, are we asking the wrong questions? Often the question seems to be dichotomous: was he abused or not? Perhaps it’s better to explore all the formative events of one’s life. What are the many ways in which our clients might have been hurt? What sense did they make of these events? How have these events contributed to their views/schemas of themselves and others?

Very little research has shown a direct link between one’s victimization and propensity to abuse. Although controversial, authors as diverse as Susan Clancy and Bruce Rind have observed that not everyone who has been abused experienced their situation as abusive, and many believe that it had little or no effect on them. Certainly, the vast majority of people who are victimized do not go on to abuse others. Yet in our rush to treat only those factors that proximally contribute to re-offense risk (in adherence to the need principle) we could be overlooking important ways to make our treatment more meaningful to our clients (in adherence with the responsivity principle). Ultimately, the question is how effectively can individual clients build safer futures when they don’t have an adequate opportunity to transcend their own past?

A couple of recent studies are worth mentioning. Reavis, Looman, Franco, & Rojas (2013) administered the Adverse Childhood Experience (ACE) Questionnaire to 151 people who had been violent towards children, engaged in domestic violence, sexually abused, and had stalked others. They found that these types of offenders had significantly higher rates of adverse childhood experiences than men in the general population. Only 9.3% of the sample reported no adverse events in childhood, compared to 38% of the male sample in the ACE study, and 48% reported four or more adverse experiences, compared to 9% of the men in the ACE study. Sex offenders in particular had significantly higher ACE scores than the general population. Likewise, Levenson, Willis, & Prescott (2014) administered the ACE questionnaire to 679 adult males who had sexually abused. Compared to males in the general population, sex offenders had more than three times the odds of child sexual abuse, nearly twice the odds of physical abuse,thirteen times the odds of verbal abuse, and more than four times the odds of emotional neglect and coming from a broken home.

Of course, not everyone responds to adverse and traumatic events equally. Authors such as Geral Blanchard have written on the understanding of post-traumatic growth, that ability not only to integrate traumatic experiences, but to find meaning from them and flourish as a result. Many clients who have sexually abused simply enter treatment looking to prevent further abuse and are not interested in an archeological expedition into their distant past. If there is anything the trauma field has learned, it’s that people who have experienced abuse need to discuss and move beyond it in their own way and in their own time. Sadly, there is far more high-quality research into recovery from abuse than recovery from sexual violence.

Perhaps the biggest question our field has yet to ask is how adverse experiences contribute to the areas that can make meaningful change seem unlikely to therapists and clients alike. It is tempting to think of the sequelae of abuse as being only things like distress and nightmares. It is easy to forget that therapy-interfering factors such as restricted affect, memory problems, relationship issues, and avoidance of situations that remind one of abuse (such as treatment for sexual aggression) are themselves trauma symptoms and not always attempts to avoid responsibility.

So how is it that our field is only now talking about trauma? Perhaps because we’re finally moving past thinking solely in terms of abuse-abuser hypotheses and understanding the nuances of adversity.

David Prescott, LICSW

Gwenda M. Willis, Ph.D., PGDipClinPsyc

PS. This blog was written with advice and contributions by Jill Levenson

References

             Levenson, J.S., Willis, G.M., & Prescott, D.S. (2014). Adverse Childhood Experiences in the Lives of Male Sex Offenders and Implications for Trauma-Informed Care. Sexual Abuse: A Journal of Research and Treatment. Avance online publication.doi: 10.1177/1079063214535819.

Reavis, J., Looman, J., Franco, K., & Rojas, B. (2013). Adverse Childhood Experiences and Adult

Criminality: How long must we live before we possess our own lives? The Permanente Journal, 17,

44-48.

Week 7: Prepped and Prepared

Drove from Mount Pleasant to Highland, then to Southgate in one day. Then drove from Southgate to Clinton township to Mount Pleasant the next day. It. Sucked. 






BUT, I got fitted for a suit and help posing from a woman I've looked up to for over a year now. Totally worth it. 







Decided on a red/burgundy suit with minimal crystals, partly because I'm a poor college student, but it also

Week 8: Plateau

Plateau. I've hit it.



Weight loss has been on track, but BF has not budged. I feel tighter in some places and measurements have changed, but getting past 13% BF is proving to be a challenge. It might help if I was consistent in my weigh-ins and when/how I got my BF measured. Oops. 



So here are my goals for week 8:



- More fibrous veggies

- Shorter fasted cardio sessions

- One, possibly