Vital Views

Joseph Gaccione 0:03
Hello, and welcome to the first episode of UNLV school nurses Podcast. I'm Joseph Gaccione, the communications director for the School of Nursing. We created this podcast to help share tales from our hard working fantastic nurses out there, whether they're students, faculty, staff, alumni or donors. These stories focus on work on the frontlines in the classrooms, in the lab, wherever our nurses are making a difference. We don't just talk about nursing, we dive into broader healthcare topics to bring attention to bigger issues that impact everybody. We also talk about ways to keep you, your family and your community healthier, both physically and mentally. April's Sexual Assault Awareness and Prevention Month, an annual healthcare observance, about the movement to end sexual assault and abuse, as well as provide resources for survivors. This is a problem that impacts millions of Americans on a yearly basis. And that includes men, women, and children. Whether it's assault, harassment, or stalking some of the eye opening statistics from the National Sexual Violence Resource Center, one in five women in the US experienced completed or attempted rape in their lifetime, and nearly a quarter of men in the US have experienced some form of contact sexual violence in their lifetime. Joining me in this conversation is Angela Aymar, Dean and professor at UNLV nursing. Among her extensive expertise is her research on supporting survivors of violence and trauma, and dating violence and sexual assault. DNA Maher is here to help shed light on the serious subject from a nursing perspective, and how we as a community can better prevent more violence. DNA more. Thank you for joining us today.

Angela Amar
Thank you for having me, Joe.

assault and abuse can have many roots. In general, what are some common causes of sexual assault and violence? What are the red flags that pop up?

Angela Amar 2:00
That's a very good question. Oftentimes, when we do research that looks at perpetrators of violence, there are some clear things that show up as patterns. Often childhood trauma, childhood abuse commonly happens, or has happened to the person, sometimes substance use is involved probably isn't the same predictable pattern, but more constellation of things that come together that create this pattern, inability to deal with emotions, inability to deal with anger, although you have abusers who can lose their temper and be angry with their spouses or their children, but certainly manage their tempers at work. And then low ego strength like not really being developed, in this self confident, grounded individual. So some some of this low self esteem, low self confidence kind of thing. Some cultural things, you know, my cheese small, although I would say patriarchy is probably a bigger thing. And there's most of the world is patriarchal. And people often use religion as an excuse for violence. But certainly the Bible says love more than it says anything else.

Joseph Gaccione 3:22
Where does the line come from? Just being angry and being physically violent versus sexual violence? Where does the sex part come into it?

Angela Amar 3:33
What I would say is that we often want, we view sexual violence is a crime that's about sex, and it really isn't. It's a crime about power. And it's a crime. It's an act of using someone's power in a way that oppresses someone else. And sex is just the weapon that used to institute the violence. But it's not a crime of sex. It's not like the person is wanting, looking for sex and figures, alcohol rape somebody it is about the power and control over someone in the making someone do something that they don't want to do, and really feel in the you talk to people who were raped, they often will say that they feared for their lives, because the idea that someone could invade your space, become a part of you connected with you and have so much total control over you also brings to light this feeling that this person could kill you, your life could end in this moment. So it really isn't a crime. It's a common thing that people think it's not a crime of sex. It's a crime of power and someone lording their power over someone else.

Joe Gaccione 4:41
On that note, are there other misconceptions about sexual assault that's out there? Based on your research?

Angela Amar 4:47
Oh, there's a lot of misconceptions have testified in a number of civil and criminal cases. And often, people think that there's one pattern sort of response to violence. And so we expect that if someone has been sexually assaulted, raped, that they're going to be upset, crying, hysterical. And there are people who become more controlled in trauma and become more contained. There are people who laugh, just because they don't know what else to do that or that's their way of responding. There are people who get angry, and who act angry people who get really sad, depressed. And so there really isn't one kind of pattern, but we expect that we would know if someone had something happened to them because we expect them to react in a certain way. We often think of sexual assault as the stranger kind of crime, we talk about Stranger danger, and people feel like that classic story is, you know, the guy who jumps out of the bushes and rape someone and most sexual assault, sexual violence, rape, are committed by people, you know, I mean, it's the smaller percentage of them that are by the stranger. And they often be cut they often happen in ways that are confusing, sorta, because people are you think about you're on a date. And so the whole thing of that idea that women are supposed to say no, and men are supposed to push for it. And so some men hear no is maybe a no as an invitation to push for further. Where No, is clearly no. And then people understand No, when your friends say you don't want to go out or do something. I think we also think that it only happens to women. And that's not true men are the victim. And often it's other men, and oftentimes straight men who sexually assault men, men are also made to penetrate someone else, you know, against their wishes. Something that we don't think of as possible, we often think that it's related to characteristics of the victim, like because you were drinking, because the way you were dressed because of the way you looked when actuality when you talk to offenders, they can't even remember what the person had on, or any of that they're looking for the person they think would be the easier target similar to other crimes. And we often blame victims a lot. Why was she in his room? Why did she do this? And I think that if you thought about other crimes that go someone broke into your home, no one's gonna say to you, are you sure you didn't invite them into your home? Are you sure you didn't want to give them your possessions? Are you sure you didn't ask them? You sure you didn't tell them to take it? All these things that sound ludicrous when I'm saying it, but oftentimes in sexual violence, we think those kinds of thoughts, so lots of misperceptions in the public opinion, then what we know from the science and the research,

Joe Gaccione 7:49
another possible misconception too, could be that it's not just an in person crime now, with the rise of digital abuse and harassment. This goes hand in hand, correct?

Angela Amar 7:59
Right. And often they go together. So it's often there's some emotional abuse or some physical abuse, some sexual abuse stalking is often related people often stalk someone to commit sexual violence. And yes, the digital especially with the root like the kind of revenge porn, the stuff where everybody's concerned about their computers and covering up the camera because other people can remotely control your cameras, the release in sex tapes, pretending to release sex tapes, extorting people but also harassing and stalking someone that way also happens as well.

Joe Gaccione 8:37
As a nurse as a health care provider. What are the intangibles and tangibles that they should have for caring for sexual violence victims?

Angela Amar 8:46
lifting meet the patient in person where they are, someone's walked in and said that they were sexually assaulted, they were mistreated. They experienced violence, we have to respond to that we have to open a supportive relationship where we hear what they have to say, we have to connect with them. They've been through a very dehumanizing exact event, someone just saw them not as a person, but as a body or their for their use, and only. And so it's a dehumanizing thing. And so we really do have to work with telling the person it's not your fault. There's nothing you could have done, you're alive, you you survive this, you will survive this, you will make it through this. So on the one hand, really supporting the person opening the door for resources, given referrals to the places they need to go. Nurses also play a role though as sexual assault nurse examiners. And so that's gathering the evidence. And so that's a delicate process. It's a police involved process, but doing we've all heard the rape kit and gathering the evidence that sort of documents the crime that can be used in a court of law is another role and that's a specialized nursing role. But every nurse should be attentive to meeting In taking care of the physical injuries, the physical demands, and really attending to the psychological needs and making sure the person feels safe and supported through this process.

Joe Gaccione 10:10
And on that line about that specialized nurse and we're talking about forensic nursing,

Angela Amar 10:16
talking about forensic nursing, and in particular, the sexual assault nurse, examiner, and sexual assault nurse examiners are specifically trained in understanding the dynamics of sexual assault, understanding the persons who walk in, and then trained in all of the collection of evidence. So that's like fingernail scrapings, and hair, combs as well as the general assessment exam, the gathering slides, all these pieces, collecting the clothing as evidence, getting the story of the person, and then they often are at trial.

Joe Gaccione 10:52
What originally drew you to this research,

Angela Amar 10:54
I'm a psychiatric nurse. And so many of the patients that I would see when I worked on a unit, or later in my private practice had some history of violence. And I often was struck by this idea that the actions of someone else can totally change the trajectory of someone else's life and can certainly extend this major kind of curveball in when you think about the trauma of abuse, abuse and major assault on the body, some, and the body reacts after in multiple ways, and you see it both physically, but you seed mentally emotionally. And so I was really drawn to this idea that there's got to be a way that we can learn more about how to help people. And most people, a lot of folks don't tell anyone, they don't seek help the viewer really, really injured, you'll go to hospital, but people don't. So they carry it around and carry this burden. And then even in my research, I've had many people who've said, this is the first time I've ever told anyone that happened. And so it really opened this door for me in terms of thinking, how can we help people to get the help they need? How can we help others to be supportive of what's going on? How do we take away some of that stigma? How do we change that to make this a better existence for people?

Joe Gaccione 12:14
And I wanted to ask about the stigma because it makes sense that someone who was raped or even stalked or harassed, might feel embarrassed to bring that up, depending on their situation. But how prevalent is that stigma in society where it almost makes the survivor feel suppressed, like they can't share.

Angela Amar 12:37
But it's huge. It's huge. If you think about it, if someone again, I'll see if someone breaks in your home, you call the police, you tell people someone broke in your home, you're not carrying this, oh my god, it must be my fault that someone broke into my home. Even if you're dressed nicely and Someone robbed you on the street, you're not carrying this thing of I should have done something differently to avoid someone robbing me. Because we view sex as this intimate act between two people. Often others don't want to get involved and people know kind of what's going on people people oftentimes gonna predict Kitty Genovese is the woman in New York who was sexually assaulted and eventually killed and bunches of Jews near this big apartments and bunches of lights came on and people looked but everybody when they saw the multiple lights come on, thought somebody else is going to respond. And so no one did. And so you know, she we had periods with her screaming all these lights come on, the perpetrator walks to side realizes no one's coming out comes back. Same thing happened like two or three times. So there's people not wanting to get involved people not been doesn't help. And then because of the sexual nature, and because we talk about it from a victim place of you know, he was raped, she was raped. We don't say this person raped this person. We seldom talk about the oppressor. We only talk about it from a victim kind of way. We as a society have created stigma around that we blame the victim for what has happened to them. And we don't always take the time to talk about the abuser. And I think we've also done this thing where we've recently economize people is all good or all bad. So whenever there's some public case that comes up, or someone accuses someone of rape, you have all the people who say, Oh, he's a great guy, she's a great person. She wouldn't do that. He wouldn't do that. And we sort of build up the perpetrator and at the same time, you have people kind of tearing down will you know, this person was a slide anyway or this person was loose, which makes it hard then so of course Spend someone's willing to come forward? Do they want to go through the scrutiny of having their life looked at it with a fine tooth comb of their life being so scrutinized? It's hard for people?

Joe Gaccione 15:12
How can we do better at being advocates for victims?

Angela Amar 15:16
I think as a society, we have to recognize that if we all want to live in a just world and a good world, then we have to take a stance in that. bystander education is one of the big things we're using now with sexual violence. And it really says that if you think about it, on college campuses, in particular, that people know the signs guys in the dormitory know, the guy they wouldn't want their sister to go out with. People know, if you're at a party, or you're out and you see, you know, two guys carrying a drunk girl, people know what that means. And so giving people the tools to be able to respond. So bystander education kind of talks a lot about the statistics, the what is sexual assault, or what happens. So that helps people to recognize it and have an awareness of it. And I think we all need to be thinking about are how aware, are we? And then the next step is really thinking about intervening. And so giving people tools, so sometimes it doesn't have to be that you walk up to someone and say, leave this man alone. But you could walk up and easily say, Can you help me with something? Can you show me this? Or if people have walked up to somebody? Hi, I'm here for Dayton, walk them away, and so that someone doesn't know. But it's there's multiple ways or your intervention could just be that you pick up your phone and call the cops and say I saw something suspicious, but there's some way of intervening and that problem. And then it's also recognizing that when we see things in the aftermath, that we're just cautious and that we stopped to think about it this person's gone through has reported they've gone through a major traumatic event. And it's not for us to decide whether or not we believe them. But it's for us to be kind and to be supportive and to not throw further injury on the person.

Joe Gaccione 17:12
Dean Amar, Thank you for joining us. There are a multitude of resources available for those who have been harmed or know of someone who has been harmed. For example, we had the care center at UNLV. And not only do they specialize in caring for those impacted by sexual assault, harassment or domestic violence, but they can also connect victims to more external advocacy groups, confidentially if necessary. You can learn more at www.unlv.edu/care Center. Thank you everyone for listening, and stay tuned for more episodes. Have a great day.

Transcribed by https://otter.ai