Interpersonal Violence and Addiction

Interpersonal Violence and Addiction

Articles Blog


– Hello, and welcome
to the next webinar in the series brought to you
Strengthening the Heartland. My name is Amber
Letcher and I am one of the coordinators
for the project, so thank you for joining us. Before I introduce our speaker, I just have a few announcements for you as we get started. First, if you have
questions during the webinar, feel free to type those into the question
box, and then I will relay those to our speaker at the end. You can also follow
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little bit of feedback and there’s also a place
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link emailed to you, and it’s also available
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strengtheningtheheartland.com. If you’d like to learn
more about the services and resources we
offer, please feel free to check that out and
also share it with others. With that, I will turn
our presentation over to our speaker, a new face to us at Strengthening the
Heartland, Michelle Trent, who is the assistant
and clinical director at the Compass Center
in Sioux Falls, and she’ll be talking
about interpersonal violence and addictions. Welcome, Michelle. – Thank you so much for
having me and welcome to everyone who is
participating today. Hopefully, today will
be a conversation about interpersonal
violence and how addictions intersect with that. Certainly, I want
this presentation to be helpful for all of you, and so if there are questions
I’ll be happy to answer them, so please make sure
to type them in. I’ll jump into just a
little bit about me. Like Amber said, I am the
assistant and clinical director at The Compass Center, which is in Sioux
Falls, South Dakota, and our focus at
The Compass Center is on working with both
survivors and offenders of family violence
and sexual violence. I have been there
in some capacity for about 7 1/2
years and have worked with hundreds of
survivors and offenders of domestic violence and
sexual violence and have really gotten a good overview of what this looks like. Certainly, this is a
hard topic to talk about in that interpersonal
violence is kind of all-encompassing. We’ll talk about definitions and we’ll talk about various
ways that it can present itself, but then also
talking about addictions and how that plays into it. We’ll jump into the
World Health Organization and their kind of definition of The Violence
Prevention Alliance and how they kind of define
interpersonal violence. Interpersonal
violence collectively is really looking at
both family and partner and community violence,
so if you’re thinking about interpersonal,
you’re talking about between two people, so that
is a lot of crime and a lot of bad things, but
our focus today really is on the family or
partner-related violence. As you see below, that
can include the partner or the child or an
elder in that family and can also include a
combination of physical, sexual, psychological, or
deprivation and neglect. What we know about most
violence that occurs in interpersonal
relationships is most people experience
multiple of these. It’s not common to have
interpersonal violence, especially in intimate
partner violence and child neglect or
child maltreatment to only have one of these. Most often, there is going
to be a polyvictimization of several of these different
categories, and so it’s kind of unique in the sense of
if we look on the other side to community
and acquaintance or
stranger violence, we would see that most often those would occur
kind of by themselves. It’s not when
somebody gets mugged, it’s not that that
person who does the mugging then follows them
home and verbally abuses them. It’s kind of unique
to family violence and interpersonal violence. In the family relationship, that has kind of all
of these components. In defining
interpersonal violence, we can see that it
refers to individuals that can be divided in
between the two like I talked about. The former category,
so intimate partner violence and kind of
family violence includes child maltreatment,
intimate partner violence, and elder abuse. All of those three things are
really kind of interconnected. We sometimes see them especially in the movement of sexual
violence or domestic violence or those
kinds of things. We tend to see each
thing as individual, but the reality is is
that we know that risk factors for child maltreatment and intimate partner
violence and elder abuse often align, so they
don’t all have the same risk factors, but
certainly several of them have commonalities
amongst the risk factors. When we’re talking specifically about intimate partner violence, what I’m talking about
today is physical violence, sexual
violence, stalking, and/or physical or psychological aggression, including
coercive acts by a current or former partner. What we’ve seen over the years is that our definition of
intimate partner violence or domestic violence has
to increase because we know that our definition of
families are increasing over our time. Intimate partner
can look different in different relationships
and can look different in different families. That intimate partner is
someone who has a close personal relationship
that can be characterized by any of the following things, so some sort of emotionally connectedness, regular contact, ongoing physical contact
and/or sexual behavior, the identity as a couple, and familiarity and knowledge
about each other’s lives. You can see that this
really branches out into populations that
include LGBTQ+ communities and men also in terms
of dating relationships or family relationships. It used to be that the
definition of domestic violence or intimate
partner violence really just included a
spouse or an ex-spouse, and we know that that’s
just not the world that we live in any longer. People are having violence
in intimate partners, or with intimate partners that are not people
that they’re married to, or with former people that they might have been
married to or might have been in a relationship with. Child maltreatment is an
intentional act or may not be an intentional
act that results in harm or the potential of harm
or the threat of harm to a child. This includes also
the failure to provide for a child’s need, the
failure to protect them from harm or potential harm, and then it can be
done by a parent, a caregiver, or an
authorized person, so an authorized
custodian of a child. That might include a teacher or a clergyperson. It could also include
a foster parent or other school personnel. This really is encompassing kind of the whole experience
of a child and could be a variety of
different things. Like I said earlier,
victimization of children especially
is rare to occur as just a singular
victimization. Most children that
are abused are abused in a poly fashion in
that they have several experiences of different
types of abuse. We also know that
there’s risk to children who are abused that they could
be abused by other people. It’s common for children
to experience abuse from multiple different sources, especially in the home. If we have perhaps
child who is living in the home with two adult
caregivers plus three siblings, it’s possible
that that child is experiencing abuse
by either of the adult caregivers and then
by the children that are in the home as well. It could also include
other generations of people, so perhaps
a grandma and grandpa come and visit,
or if stepparents or stepsiblings,
those kinds of things come and visit, that could
also be a potential person that might harm that child if they are experiencing
harm in the home. In terms of talking
about both alcohol and other drug and
interpersonal violence, so addiction and
interpersonal violence, there’s two ways to look at it. The first thing, to look
at it from the offender perspective, and then
the second being to look at it from the
victim perspective. We’ll take a look at
both today because both are important for us
to really acknowledge that addictions impacts
interpersonal violence in different ways whether you’re the offender or the
victim, and so we’ll talk about both of those today. Really, looking at the
statistics and the kind of offender’s prevalence
of substance use, we can see first of all in
intimate partner violence that, first of all, kind of acknowledging the
limitations of research. Limitations of research
in intimate partner or child maltreatment
are high in that we know that reported
occurrences of both types of things is probably not the accurate
number in that most or, not most, lots of
both intimate partner violence and child
maltreatment goes unreported. Statistically speaking for
intimate partner violence, there are statistics that say for every one act of violence that is reported, there’s
a potential seven to 10 acts of violence that occur that don’t go reported. If you have a home
where someone is calling the police because of
a violent incident, there is likely that
there was many more violence incidents that occurred to that household
or to that victim before or after law
enforcement was called or it was reported. The same goes for child abuse, and many of you will know this
having worked with children. A child might experience
multiple forms of abuse before something is every caught and reported by someone
else or before that child ever reports that
to authorities, and so children,
A, don’t often know that what they’re
experiencing isn’t the experience of others or
isn’t what’s supposed to happen. The younger the child is, the more unlikely they are to have other
experiences that tell them that people shouldn’t
treat them that way. Their incidences of
reporting are not real high, and so we know that our numbers for intimate partner
violence and child maltreatment are low compared to what the probability of
those occurrences happening is in the real world. When looking at these statistics as we go forward today, know
that the numbers listed here may or may not be
extraordinarily higher based upon the things
that are being reported. Looking at the numbers
that we do have, we can see that any
intimate partners, the statistics tell us
that in about 40 to 60% of incidents there is a
co-occurring use of substances. That could be immediately post-incident, or
immediately prior to incident or
immediately post incident, but that 40 to 60%
of violent incidents that are reported include
some sort of substance use. The next piece that we
talk about is alcohol and/or drug abuse
by the male partner was the strongest
correlate of violence. We know that in terms of
looking at risk factors, men that abuse alcohol
and drugs are more strongly correlated
with violence in their relationship. Not that all men who
use alcohol or drugs are violent, but that
there is a correlation between the two. We also looked at the
fact that during times of heavy drug use that
interpersonal violence or intimate partner
violence is 11 times more likely in times
of heavy drug use. If you have someone that
may not have displayed any violent tendencies
ahead of their drug use, it’s possible that
heavy drug use can be a precursor to
violence, but we know that it’s more likely going
to happen when a person has been using heavy drugs
that they’re more likely to engage in intimate
partner violence. Then, more than 20%
of men report alcohol and/or illicit drug use
preceding incidents, so this is a tough statistic in that this relies on men
reporting their behavior, and many of these statistics
are related to men. Unfortunately, what we
know is that violence occurs across genders in
intimate relationships, and so much of our
statistics relates to men because that’s
the most common form of reported violence
in relationships, but especially for men,
it is very challenging for men to report
intimate partner violence for a lot
of societal reasons. We live in a society
that promotes masculinity, which
then essentially says, The man is the stronger person, the man is the person that
controls the situation, so in the event that a man is abused by their
female partner, that’s really hard to talk about because they will perhaps
be looked down upon. There’s also occurrences
and reported statistics that tells us that
often men’s experiences with violence are devalued or that they are not treated in the same experience as women. It’s often kind of like
we downplay the abuse that men experience
at the hands of women, and so men are then
likely not to report the significant pieces. If a man says, “This is
what happened to me,” and somebody says, “Are you
sure that that’s what happened?” Or, “Maybe it looked different.” Or, “How could you
be beaten up a girl?” Then, men are less
likely to talk about the things
that are occurring. Our statistics are very
male offender heavy, which is unfortunate because
then we can’t actually look at the realities for women
offenders and male victims. Additionally on the statistics, we can see that
this is reported, so this is people
that are voluntarily reporting that they used
alcohol and/or drug use preceding the incident. It’s very likely that
people are not real motivated to tell the truth here when we’re asking
them those questions. Most often, especially
for folks that may not acknowledge their
problems with alcohol or drug use, so they
may have a problem but they’re not in the
point of being able to acknowledge it,
they’re going to downplay the impact of
alcohol and/or drugs in the violent incidents that they
have perpetrated. For child maltreatment, we know that in about 35% of cases
reported, excuse me, reported, and these are reported
to either law enforcement and/or child protection and is specifically related
to parental child abuse, we can see that 35% of
those incidents consumed alcohol or drugs during
the time of the incident. There is alcohol or drug
use present and being consumed at the time
that child abuse in whatever form occurred. Then, the other
interesting statistic here is that having
a history of harmful or hazardous alcohol
use increases the risk of child maltreatment, and so this is really looking
at if there is a history in the home, if there is
a history of caregivers, if there is a history
of child use of harmful or hazardous alcohol use,
that increases the risk of child maltreatment, which
is an interesting thought. What we know about
substance use, of course, and many
of you know this, this is not rocket
science by any means, but we know that alcohol, that drug use of all
sorts has a combination of these things. First of all, it
lowers the inhibitions, so we know this. We can see this by going
to any college campus on a Friday night
and seeing the kinds of things that folks that are
consuming alcohol engage in. They’re are definitely things that are not going to be
things that would be typical. There’s a little
bit more restraint when a person is not under
the influence of substances, so it lowers inhibitions. Certainly, some
substances increase energy and activity,
so if we have a person who is consuming a
high amount a substance or if it’s a substance
that’s very potent, their energy and activity
levels might be impacted. We also know that substances
increase poor decision-making. Going along with
the inhibitions, people tend to not
make the same decisions that they would make
when they’re using a substance as when they aren’t. We know that increased
agitation can occur with substances, so we
know that regardless of the substance, this
is documented in lots of substances that
agitation can occur. Agitation interestingly
with substances can occur at different points. I’ve worked with folks
in the past that say, “I’m a happy drunk,”
but then they’ll say, “The more I drink, the
more agitated I get.” Alcohol may delay
that agitation, but it doesn’t mean that that
agitation won’t be there. Then, we have other
substances like meth use where we might have
somebody that uses meth and they are agitated
right in the beginning, and as they come off
of that substance, their agitation decreases. Interesting to think
about the point in which violence could
occur with those folks based upon agitation and
we’ll talk more about that coming up as well. We also know that
there are increased difficulties in communication when someone is
using a substance, so if someone is intoxicated
or using heavily, we know that their ability to communicate about
important things goes down, and then we also know
that substance use increases personal stress. Substance use obviously
creates financial concerns in some situations and in some homes it might
also lead to work problems, so perhaps a person
is getting terminated from their job or having
work-related issues. Then, it also leads
to home problems. If we’ve got let’s say
a person who is using substances, their
ability to care for the children in
the home goes down. Their ability to
contribute to the home, so doing laundry or
dishes or all the things that are day-to-day
things decreases with their substance use. What’s interesting about
this is we could say that this is also a
list of risk factors for violence in
intimate relationships. All of these things
contribute to violence happening within
a family setting. When people are under
additional stress, when there is
increased agitation, when there’s poor
decision-making, increased energy or agitation, those things all
lead to or can be part of what leads to
violence in the home. Certainly, it doesn’t have to, but these are
certainly risk factors. We also know that risk
factors exist in terms of the socio-economic
status of folks, and so if you have
people that are coming from maybe increased areas where there’s financial
stress, so increased poverty and those kinds of
things, that can certainly be a risk factor. We also know that people
who have experienced trauma in their
history are more likely to engage in substance use, and so that’s also a risk factor for violence within
a relationship. You can see how the risk
factors and the problems created by substance
use also are part of the risk factors
and problems that lead into violence in relationships. Oops. If we go on here, I think that this is a really
humorous slide that talks about correlation
doesn’t imply causation. This guy up here has a headache when he has his shoes on
in bed, but this other guy is pointing out, “Yeah,
you were drunk last night,” so the shoes on in bed probably are not what caused
the headache. The shoes on in bed
are a correlation, but they’re not the cause. Certainly, when we’re
talking about violence in relationships, the
statistics tells us that and the research tells us
that although substances are correlated to violence, that they are not the cause
of violence in a family or in an intimate
partner relationship. Oftentimes, we have
people that say, “Well, if we just
treat the addiction, “if we just treat
the substance use, “we get rid of the violence
in the relationship,” but when you really sit down and look at violent
relationships, people miss often
that the violence is not just the physical
act of punching somebody or the physical act that
causes a physical injury. What we know about
intimate partner violence is it’s less
about anger management and violence and more
about power and control. If you take victims and
perpetrators of violence in a family or in
a relationship, including child maltreatment, and you go back over time, it’s rare that that
violence occurs in a vacuum. Typically, there’s
other predictors. Typically, there’s other
pieces that are involved in this, whether or not the
person is on substances. For intimate relationships or domestic violence if
you talk with victims of domestic violence and
talk about things like what happened
before the violence, they’re going to
tell you things like, h or she was really controlling. He always knew where I
was going and made sure I was going to the
places that I said. He would show up at
my work to make sure that I was there. He or she looked at my phone and got mad when I was talking to people
that they didn’t think that I was supposed
to be talking to. He or she did all
sorts of other things up to aggression and
violence, but there’s a whole bunch of other stuff
that exists in there, and often people will
say that those things didn’t occur just
when the person was on a substance. They might have gotten
worse when the person was on a substance, but
they didn’t just occur when they were on a substance, so sober or not, those
things were happening in that relationship. Again, looking at children and when we’re talking
about child maltreatment and the fact that many
children are polyvictimized, they might have physical
violence occurring in their home when their
parent is intoxicated, but they might have neglect
occurring in their home when their parent is sober. Child maltreatment
and intimate partner violence are
certainly correlated. We know that when people
are using substances, violence and those kinds
of things can increase because of all of
those things we talked about on the last
slide, but we know that that is not
what causes violence. Another really I think
humorous causation and correlation piece is to
think about ice cream sales and murder rate tend to
go up at the same time. The murder rates go up
for a variety of reasons and so do ice cream sales. It’s not necessarily
that ice cream sales, it’s not that people
that are going out and eating a ton of ice
cream are the people that are murdering others, it’s that the
temperature increases and we know that that
has correlation to both ice cream sales and murder rate, so it’s the same thing here. We could change out these two. If we replaced alcohol
or substance use in the spot that says ice
cream sales and replaced interpersonal violence
with murder rate, we would see this
exact same thing, that certainly substance
use might go up and create violence and
those kinds of things, but it’s certainly not
what’s causing those pieces. In terms of looking at how
do we work with offenders who are using substances but that also are
perpetrating violence in their interpersonal
relationships, I think that the most
important thing here is to really look at the
fact that substance use and interpersonal violence have correlations,
not causations. Therefore, we can’t
expect to resolve one problem by fixing another. It’s good for folks to
go and get treatment for their substance use,
and at The Compass Center and every great crisis
center or domestic violence agency that I
think is in existence in the world, we would say, yes, that person should
go and get treatment for their substance use
and substance dependence, but we know that just
doing that doesn’t solve the violence problem. We know that their
controlling behaviors, manipulative behaviors,
violent behaviors occur at the same time
as substance use but don’t occur because
of substance use. They’re not caused by it, so only fixing one problem isn’t going to actually fix violence. If you’re working with
someone who is both violent and addicted
to a substance, knowing that both
of those pieces need to be addressed and
hopefully simultaneously, but systems are not
always set up that way. Certainly if not simultaneously, then at least one
after the other to really address those pieces. The next really
important thing here is to recognize that
substances can often be used as an
excuse for violence. In society, we kind of
create an out for people who are violent by saying,
“Well, they were drinking.” If we see a bar fight, that’s happening and we go,
“Well, they were both drinking,” so that kind of
justifies the violence a little bit in our minds. This same then gets
passed on to other people who use violence when they are intoxicated,
and so many times you’re going to be working
with an offender who says, “Well, I don’t have a
problem with violence, “I have a problem
with substances.” Part of the work that we have
to do in helping those folks in whatever capacity
we’re working with them on is to help them recognize that these are two
different problems that both need addressing. We can treat the violence, but if we don’t
treat the substances and you continue to
use the substances, your are inhibitions
are going to go down. Even if you work
really hard on changing your violent behavior, when
you consume a substance and your inhibitions go down, your ability to not do
those violent things that you’ve been working so
hard to stop goes down as well. The same if we flip
it on the other side and are thinking
about substances and if we treat substance
use, that’s great, but sober people
are still violent and we have to
treat the violence. Not only the violence
but the controlling behavior that goes along
with both child maltreatment and intimate partner violence. In both of those cases,
much of the violence that occurs, much of
the behaviors that occur are related to control and power rather than to anger management. If we don’t address the
parent who feels like they have to have
ultimate authority over their child, even if we
get them off substances, if that’s still their belief, if they still display
those controlling manipulative
behaviors, that child, even if they’re not
getting physically injured, they’re still
at risk for maltreatment because of psychological
aggression, because of neglect and all
of those kinds of pieces. This is a multifold issue that has to be treated as
such, not just one thing. The danger if you have
somebody that says, “Substance use is my problem,” they’ll go through treatment, they’ll get sober, and
then they’ll go back into the environment
where those other pieces were occurring and
that violence is still occurring for that victim. Then, the other thing to
know is that certainly statistically speaking,
we know that most, not most, many offenders
are also victims of some sort of
violence in their life. Thinking back to
like the ACEs Study and all of the
things that we know about traumatization
and victimization, we know that trauma is part of
the risk factor for violence in a
variety of ways. If you are working
with an offender, the likelihood that
they also experienced their own victimization
is high and that needs to be assessed for. If you’re working in a
substance abuse facility or if you’re working in
a counseling facility or school facility,
we can’t discount the possible correlation
between past experiences and their offending
behaviors now, and especially teenagers. If you think about
teenagers and children, oftentime we see, many of
you that work with children are probably very
much in agreement with this that many of the
times when we have children that are violent,
when we have children that are offending even in
their own intimate partner relationship, if
we really look back in their history,
we find a history of their own victimization. We can’t treat their
offending behavior apart from their victimization
behavior because the two are connected, and that’s
also then connected to their substance use. You can see the
problematic nature of treating one of these in a silo from others, and so knowing that,
it’s an important part to look at that
person as a whole. Now, we’re going to kind
of switch gears and look at the victim and how
alcohol and other drugs and interpersonal
violence intersect with the victim specifically. Certainly we know that
statistically speaking on the last slides, we
talked about the amount of offenders using substances
in violent relationships and violent interactions. Now, we’re going to
talk about victims and their use of substances in
their relationships as well. First of all, really thinking
about women substance users. Again, here the statistics and the research about
men being victims is poor. We just don’t have it
because the domestic violence movement started out of a feminist movement,
and so of course, in the beginning
of that movement, people were more likely
to look at domestic violence as being the
woman is the victim and the man is the offender
because it really did start out of that
feminist movement. Not that that is a bad thing, I think that that needed
to happen in a lot of ways, but there are
limitations created by that, then, in we
have been less likely to study men who are victims
of violence than women. Many of these statistics
could also be true for men in a variety of ways, we just don’t always
have the research to tell us those things,
but anecdotally speaking, I can tell you that many of
these things are the same. In the work that we do
at The Compass Center, we provide an offender
treatment program for both offenders
of domestic violence and then we also offer
services to survivors, and we know that many
of the men coming into our program, a large
percentage of the men coming into our
program are victimized themselves in some capacity. Certainly, our experience is that they are more
likely to be victims. Research is catching up to that. This slide talks about
women substance abusers are more likely to be
victims of violence, so this is an
interesting statistic that talks about women
who are currently substance users that
become victims of violence. There’s a lot of reasons
for this, and again, talking about polyvictimization, so statistically speaking, if you have experienced
one violent interaction, so if you have experienced child maltreatment in your life, if you have experienced
a sexual assault as a child or as a
teenager, you’re more likely to experience those same
things going forward. Many people might have
started a substance addiction when after a
victimization occurred perhaps when they were
a child or perhaps when they were younger
and so they might start, it’s kind of the chicken
or the egg argument here about what starts
first, the substance use or the victim of violence
and it’s hard to really kind of pin that down. We know that at the time
of this research looking at women substance
abusers are more likely to be victims of violence. This can be looked
in multiple ways. First of all, people
who are intoxicated are sought out by perpetrators, so statistics tell
us that perpetrators, especially of sexual violence, of intimate partner violence, look for vulnerabilities. Substance abuse creates
a vulnerability, and so they look for people
that are more easily controlled. If we really believe and
the research tells us that intimate partner
violence is about power and control, then
it stands to say, stand to be true
that perpetrators are going to look for somebody
that’s easier to control. Substance use creates that, so if you’ve got a person who is on substances, especially
a heavy substance user, the ability to control
them is much higher than a person who is not. It’s a weapon used
by perpetrators. We also have seen
and do see instances where the perpetrator uses
the alcohol or the drug as a weapon. They might actively get
that person intoxicated so that they’re easier to abuse. This is especially the
case with sexual violence in that it’s much
easier to sexually abuse somebody
who is intoxicated and is unable to be really
in control of themselves than it is to
sexually abuse someone who is not intoxicated. It’s a weapon used
by perpetrators when they see somebody
who is on substances, but then is also
used as a weapon to get somebody intoxicated. You’ll see this in bars
across the country, you’ll see this in
homes across the country where the perpetrator
encourages the use of alcohol or they
might say things like, “When I’m drunk I
expect you to be drunk.” even if that other
person does not want to be intoxicated,
the expectation and the threat is, “If you don’t
get drunk when I get drunk, “then you’re going
to be injured.” the other thing to know
here is that substance abuse for folks decreases
their ability to stay safe or follow safety plans. In the event that
someone is intoxicated, they might have intentions to call a friend for a
ride home when they get intoxicated or they
might have intentions to stay sober on
that particular night and have safety plans
in place for themselves, and then they become intoxicated and they can’t follow those
or they can’t recognize unsafe situations because
of that intoxication. Certainly, that
creates an opportunity for perpetrators to
utilize against then. We’re always very
careful here in talking about this because
people will often use things like, “Well,
she was drunk.” Or, “He was drunk, and what
did they expect would happen?” This is a common myth that
we at The Compass Center and in my work with victims I really try to combat in
the sense of we’re using substance abuse as a
way to blame the victim when the reality here
is that perpetrators are choosing to perpetrate and
they’re looking for someone. You can see this happen. When there’s been
research that’s happened and talking with perpetrators, they’ll tell you that
they went out looking for someone to
perpetrate against. If they couldn’t find
it with this person, they’re going to go
to the next person. It’s not that that one person who was intoxicated caused it, it’s that they were
found by the perpetrator who then chose to use
abuse against them. A slight shift in the
way we view things, but an important shift in
the way we view things. On the flip side, we
know that substance abuse is higher in women
who have experienced interpersonal violence
than women that have no interpersonal
violence experience, and the same goes for men. They are more likely
to use both tobacco and marijuana, and they
are 70% more likely to heavily drink alcohol. This makes a lot of sense if you work in the trauma field
or if you’ve worked with victims in that people
are constantly searching for a way to numb
their experiences, and so if they have
been a victim of extreme violence, they are
looking for an extreme way to numb themselves. Substance, then, create
the opportunity for them to numb out of those things. There’s a high risk for
people who are using substances before they
were ever a victim of violence, but then
there’s also a high risk for people to begin
using substances after they’ve been a
victim of violence, which then if you’re kind
of following along here, then, if we look
at the second piece that says they’re more likely
to engage in substance use, then we circle
back up to the top portion that says
they’re more likely to be victimized, which
then says they’re more likely to use substances, which then says they’re more
likely to be victimized. We just spin around
in this circle. Substance abuse, when
you’re looking at it on the victim side,
is really kind of this spinning, that
it’s more likely to occur in a variety of ways and then
it’s really hard to stop. Once you get into that cycle, it’s a really hard
thing to change, and so we have lots of victims who are victimized multiple
times and have multiple experiences with violence in their relationships and
substances being a part of those things. Things to keep in mind
when you’re talking about working with victims. Certainly, the first one talks about that substance use can
be a preexisting condition before the violence or it
can be a result of violence. Knowing which one is important, and I have in here
necessary for healing, I want to talk about
that a little bit in the sense of we have to
know that work in substance use can better talk to, or substance treatment
can better talk about this, but knowing
kind of what triggers for substance use are
are really important. Here, we need to know,
where did the trigger start? We might have to go back
through 10 different victimizations to
find when that trigger started, but knowing,
did they drink before they experienced
that particular violent act? Or, did they start
drinking after? Tells us something
about their behavior. It tells us on the flip side,
if they’re using it after, it tells us that they’re numbing and that’s a very
specific thing. If we treat the substance use there and we take away
their ability to numb, we’re going to throw them right into that trauma and they
don’t have the ability to cope with that, and so knowing that they started using
after the violence tells us that we have to work a
lot on coping skills. We have to work a lot
on replacement behaviors because if we strip
away the thing that they’re using to numb
and they don’t have the skills to be able to cope with
it because they didn’t when they started using
their substance use, we know that they’ll probably just go and find a
different way to numb. That other way to
numb is probably going to be just as unhealthy. We take away their
use of substances but then we talk about
there’s lot of cases of folks then getting addicted
to shopping or gambling or food or the list
goes on and on. If we take away
substance without knowing that this is
the way that they numb, we run that risk of
just sending them into another addictive behavior. The second one here is the same as I put on the working
with offenders slide because this is a really
important thing, to recognize that substance use can
often be used as an excuse for violence and then
that may cause victims to excuse behavior once
substances are used. It is very common in the
work that I have done. I can’t count the number
of times that I have had this conversation with
victims where they go, “Well, if they’d just
stop drinking,” or, “If they’d just stop using meth, “then they wouldn’t be
violent any longer.” I have been on the
flip side of that, seeing how that doesn’t work. I’ve worked with survivors before that said, “Yep,
they just need treatment,” and that person goes
and gets treatment and they get off the
substances and six months later that person is back in
my office going, “Well, “they’re off substances
but they’re still violent.” We have to help victims
understand this as well. We have to help
victims understand that there is a correlation
but not a causation and understanding that
substances are part of what needs treatment,
but that that person also needs to choose to change their controlling, manipulative, violent behaviors in
order for that violence and child maltreatment to stop. This is often the
case with kiddos, so if you think
about little people and the way that
their brains work, they see Dad or Mom
consuming alcohol and then they feel Mom
or Dad hitting them. In their minds they go,
“Well, if Mom and Dad “would just stop
drinking alcohol, “then they would
stop hitting me,” which is a really simplistic way of looking at
things, but we know that that’s not true. For kids, this will
often be a challenge because they’ll come in and say, “Mom and Dad don’t
have a problem. “Mom and Dad aren’t bad. “Mom and Dad just drink. “Mom and Dad just use drugs.” Helping them, of
course, developmentally appropriately to understand that there are multiple
problems here that Mom and Dad need to address,
substances included, but also the other
pieces that contribute to the maltreatment for them. Then, the most important
thing for survivors and victims is that safety
much be addressed first and foremost, and thinking about how substances impact a
person’s ability to stay safe, we have to get them to
a safe place right away. If you’re working with
somebody like in a detox environment or something
like that that comes in and they are on substances, they are not safe to
go back to their home because of the violence
that occurs there, so we’ve got to figure out
a different plan for them. Maybe that is staying in detox, maybe that’s going to a
shelter after they sober up. Something that safety
must be addressed, and so we can’t help a
victim if we don’t take into account the
way that substances are impacting their
ability to stay safe, so really safety
planning is a really key piece of what we do with victims
in order to help them heal. Then, of course,
these are references that you can look back at,
too, and there’s a variety of them, but I think
this is an overview of, how do we define the
intersection of intimate partner violence or
intimate relationship violence and substance use? We can see that causation, or that correlation,
but certainly not the causation. Unfortunately, we don’t
have real good research that tells us what
causes violence. We have some thoughts
and some theories, but certainly we don’t
have the answer yet. These are very challenging folks to work with, both
offender and survivor, because there is so
much polyvictimization, there’s so much kind
of interconnectedness of all of these things. We used to treat this
as treat each individual piece separately, and
more so the research now is going to these are
not independent problems from one another. The treatment
options really I see an opportunity in the
next 10 to 15 years to really expand what we’re
doing to be able to better treat these folks
that have significant experiences of
violence themselves that then might create some
risk factors for their own perpetration, but
then might create risk factors for substance use
or substance dependence. Certainly, this is
an intro to this kind of conversation and it’s
a tough conversation to kind of talk about in depth, but certainly I’d
be willing to answer questions if there’s
specific questions about any of the
pieces that I’ve talked about or further pieces
that you wanna know about. – Thank you so much, Michelle. We do have some
time for questions, so if anyone would like to type those into the question
box, I can definitely relay those to Michelle. As I was listening, you
mentioned the ACE Study, and I also wanted to
draw our participants’ attention to our
previous webinar that we also reviewed
the ACE Study, so if you’re interested
in looking at that, more information about that, that’s available on our website, strengtheningtheheartland.com,
I’ll just plug that again. One thing while we
wait, we’ll give people a chance to type
in some questions, you talked a lot about how
there is some research gaps. There’s also some stigmatization particularly with men
who might be victims. I’m wondering if
you would know of or if there are trainings
for people who might work in areas where they see
intimate partner violence to kind of maybe get rid
of some of that bias. Or how would you talk
to a male who might have experienced victimization so
that they don’t feel ashamed? – Totally great question. I wanna first pause and
talk about the ACE Study and kind of I’ll plug
that a little bit. I think more and more we
need to as a community that works with people recognize that this study really
should dictate the work that we’re doing with folks. If you’re not familiar
with the ACE Study, I think it’s imperative
for you in whatever capacity that you’re
working with people that you look at that. It has so many implications for everything that we do, from education to mental health to medical to
community resources and the way that we
treat homelessness. Just every I think problem that we’re talking
about, the issues that we’re talking
about today included, goes back to looking
at those pieces. If you’re not familiar,
if you’re not utilizing those resources in
your professional work, I would strongly
encourage you to do so because I don’t think
that we can work with humans without
knowing those pieces. Especially in the world
that we live in today when we know that violence in those conditions
is increasing, when we know that
the amount of people that have experienced
those things are higher than they’ve maybe, I don’t
know that they’ve been before, but they’re certainly high. We can’t work with
people in whatever capacity that we work
with them without acknowledging their experiences in adverse childhood
experiences. On that note, we’ll
transition to certainly working with men. The good thing I think
is that there are a lot of national organizations that are starting to recognize
that working with men who have experienced violence, whether in an intimate
relationship or sexual violence, is kind of a unique specialty and it’s different
than working with women because of unique
experiences that men have and the same goes
for folks that identify as different genders or
gender non-binary folks that there are specific issues that are important to
acknowledge and address for those folks. There’s a variety of
different organizations. There is, 1in6 is an
organization that works with men survivors
of sexual violence. The National Sexual
Violence Resource Council has begun working with more men. Unfortunately, we’re
just at the start of that and men are really
kind at a disadvantage in some ways, men
who are victims, in finding a person who
is familiar in working with those folks. Really, for men that
you’re working with, it’s important for us
all to continue to dig into the research, to
dig into the trainings that are out there
because as we go forward there’ll be more. There hasn’t been a ton yet, and so that’s certainly
an area of opportunity I think in our field. Other than that, I don’t
see any questions coming in, so we will end for today. Thank you so much, Michelle. This was such good information and your willingness
to share it with us and your experience is
just really valuable, so we appreciate your time. – Well, certainly,
I’m open to folks can get in
touch with me as well. You can certainly email me. It’s
Michelle,
[email protected] If you have specific questions, or more in-depth
questions about the work that we do, or the
work that we do to help trauma victims, or
any of those kinds of things, certainly
feel free to reach out. Or, if you’ve got
clients that need our services, feel
free to reach out. I know there are
folks that are coming from a variety of areas,
and so you might be going, “How can I connect
people in my area?” Certainly, reach out and
I can get you connected with the right crisis
center or the crisis center that’s in your area
that specifically works with these types of issues because there’s great
ones all across our state and all across the
Midwest and the country. I can certainly point you
in the direction of those. Thank you so much for having me.

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