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What to say to someone who shares a sexual assault story with you

Recent sexual assault allegations against Hollywood producer Harvey Weinstein prompted a widespread response on social media: the #MeToo campaign.

For survivors who chose to share, the campaign has been a powerful tool for bringing awareness about a widespread issue and sparking cultural change.

Yet, when survivors are sharing their stories with others, knowing how to sensitively respond, or if you should respond at all, can be unclear.

Beth Enterkin, a trauma therapist and clinical training specialist at Rape Victim Advocates in Chicago, offers her expertise on ways untrained listeners can best support someone who chooses to share a sexual trauma story. The conversation has been edited for length and clarity.

Q: What should you say if someone feels comfortable enough to share a sexual trauma with you, but you feel unqualified to help?

A: There are three go-to statements if you don't know what to say: "I believe you," "It's not your fault" and "You have options." Many survivors are questioned, and with disbelief, comes victim blaming. The third (statement) speaks to the trauma of feeling that your options were taken away from you, like being able to say no, or advancing your career without enduring unwanted advances. Survivors should be re-empowered with the right to make their own decisions.

Q: Asking questions can communicate care but, in this case, can seem insensitive. Should the listener ask questions?

A: Disclosing trauma should be at the survivor's pace, so we tend to steer people away from asking questions; that can feel invasive, and we want survivors to feel in control of what they share. But, if they allow you to ask questions, make sure they are not phrased in a way that insinuates victim blaming. Asking, "How did it happen?" feels a lot different than "Why did it happen," or, "What were you doing when it happened?"

Q: Are there other ways to show compassion, then, perhaps with body language?

A: Don't fold your arms or look angry. That reaction is understandable, but you don't want your anger to seem directed at the discloser. Also, it may feel very natural to rest a hand on a shoulder or offer a hug, but explicitly ask for consent before jumping to that physical touch.

Q: Should your response differ based on your relationship with the discloser, such as a co-worker versus a loved one?

A: It's important for survivors to still feel accepted and not viewed as dirty, damaged or different just because of what someone did to them. Respond to the people in your life who have been harmed as if they still are themselves, because they are.

Q: How should someone navigate receiving a disclosure across gender lines?

A: Men who hear disclosures from women should remember this isn't about them. Some men can feel judged in these things and have a reaction of "don't lump me in." Keep things focused on the person who just disclosed, by being mindful of what feels comfortable to them.

Q: How do you tell someone you can't provide additional support and suggest professional help?

A: The person who suggests getting help from a rape crisis counseling center should be sure to present it with love and care, articulating concern and a desire for their loved one to receive good support. They can say, "I'm not experienced in these things. Would you be open to going to counseling." Or, "Is there some other way I can help you find another way of support?"

Q: What if you're not comfortable talking through this with the person because you've been through something similar and aren't ready to share?

A: That's where it's even more important to say, "I believe you," "it's not your fault" and "you have options." If that's all you can say because you're dealing with your own trauma, and saying anything beyond that feels too triggering or too much for you, that's OK. Know that you've done a world of good with those three phrases.

Q: What do you do when someone tells you the harassment or assault is ongoing?

A: It can be tempting to swoop in, find the answer and rescue somebody who's being hurt. But when you rescue somebody, you imply that they're not able to help themselves, and that can reinforce the trauma of feeling like they don't have control over what's happening to them. Let them know you're there for them, that you value their safety and that you would like to help by connecting them to options.

Q: What should you do if the person sharing is under the age of 18?

A: That depends on your role. If you're a teacher or a health care provider, you are a mandated reporter by law. But if you have no legal obligation to hand over the report, keep their age and social context in mind. For young children, the abuser is either a family member or close family friend. This child may have caring feelings for the abuser, and that can be extremely confusing and hard for them to come forward. If they've trusted you with this information, know that it was hard for them and it's important to believe them.

Q: Can you talk about the differences among harassment, assault and rape?

There are legal definitions that differ in each state. In Illinois, legal terminology covers harassment (verbal or threatening without touching), abuse (anything that involves nonconsensual touching or fondling) and assault (anything that includes penetration). But I mirror the language that the person in front of me is using. However they feel about their assault and whatever term they use to describe it is whatever term I'm going to use when talking to them. Again, that re-empowers each person to take back control over their lives, starting just by how they talk about what they've been through.


Health-med-fit
Research finds hot flashes, night sweats connected to obstructive sleep apnea risk in middle-aged women

ROCHESTER, Minn. - In a new study published recently in Menopause, researchers have found that the hot flashes and night sweats faced by upward of 80 percent of middle-aged women may be linked to an increased risk of obstructive sleep apnea.

Obstructive sleep apnea, the most common form of sleep apnea, is characterized by repeated stopping and starting of breathing during sleep. Besides affecting the quality of sleep, obstructive sleep apnea can lead to serious health concerns in women, including increased risks of coronary heart disease, high blood pressure and stroke.

To track this occurrence in middle-aged women, researchers used the Data Registry on Experience of Aging, Menopause and Sexuality, which contains health information on women seen in the Women's Health Clinic at Mayo Clinic.

The team found that, of the women seen between May 2015 and December 2016, self-reported severe hot flashes and night sweats were linked to an intermediate to high risk of obstructive sleep apnea. While those who had high blood pressure and were obese were at an especially high risk, the risk also was seen even in women with a healthy body mass index.

"Obstructive sleep apnea is often thought of as a man's disease, and men's symptoms are more outwardly noticeable, in large part because of snoring," says Stephanie Faubion, M.D. "However, the risk for obstructive sleep apnea in women goes up in their menopausal years. The symptoms they face _ headache, insomnia, anxiety, depression, in addition to the more common symptoms of snoring and fatigue _ may not be as audible or visible to others, but they pose just as much risk to overall health."

Two years after clinical consultation when women self-reported their hot flashes and night sweats, 65 percent of the group that demonstrated intermediate or high risk of obstructive sleep apnea still was not diagnosed with the condition.

"Hot flashes and night sweats may be overlooked as a risk of something more serious," says Dr. Faubion. "The implementation of screening tools during evaluation can help determine what symptoms women are facing, and put us on track to detect and intervene with serious health issues, such as obstructive sleep apnea, sooner."


Tim Hynds, Sioux City Journal file 

UnityPoint Clinic Family Medicine -- Sunnybrook has been recognized as a Level 3 Patient Centered Medical Home.


Health-med-fit
UnityPoint Clinic recognized for patient care

SIOUX CITY | UnityPoint Clinic Family Medicine -- Sunnybrook has been recognized as a Level 3 Patient Centered Medical Home (PCMH) by the National Committee for Quality Assurance (NCQA).

To achieve this recognition, the clinic was successful in demonstrating excellence in care management, patient focused huddles, setting patient goals and identifying barriers, chart preparation and charting to rooming standards.

UnityPoint Health -- St. Luke's said in a statement that UnityPoint Clinic is transforming its primary care practices to a medical home model to improve patient-centered, coordinated care for the patients and communities it serves. The NCQA PCMH standards emphasize the use of systematic care management that supports access, communication and patient involvement.

The statement said the addition of care coordinators to the UnityPoint Clinic medical home team helps empower patients to be active participants in their health care. A care coordinator is a registered nurse who provides additional education on medication, nutrition, exercise and other topics important to a patient, assists them with goal setting and coaches them to develop a plan to achieve their goals.

PCMH data shows promising results in improving care quality and lowering costs by increasing access to more efficient, coordinated and responsive care.