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Seeking Help For Sexual Assault

Posted on by Dr. Annie Abram

Every victim/survivor of sexual assault responds differently. Some common emotions are anger, fear, guilt, loss of control, powerlessness, embarrassment, depression, isolation, denial, shame, disbelief, self-blame, and emotional shock. ( And when victims/survivors do not receive the support they need to heal, these feelings can last a lifetime.

On my radio show this week, I was honored to have as my guest a woman who has devoted her life to helping sexual assault survivors get the help that they need. Laura Cordes is the executive director of the Connecticut Sexual Assault Crisis Services (CONNSACS), the coalition of the state’s nine community based sexual assault crisis services programs and Connecticut’s leading voice to end sexual violence. An advocate and organizer for over twenty years, Laura has worked on numerous women’s health public policy initiatives. She has spearheaded the effort offering emergency contraception for rape victims in all of Connecticut’s hospitals. She’s also helped develop the state’s Sexual Assault Forensic Examiner Program, which allows women immediate access to specialists that can deftly perform the invasive procedures necessary to collect evidence of rape. She is also a statutory member of the State of Connecticut’s Criminal Justice Policy Advisory Commission, the Commission on the Standardization of the Collection of Evidence in Sexual Assault Investigations and the newly created Governor’s Victim’s Rights Enforcement Advisory Commission.

Generally speaking, according to Ms. Cordes, about 20% of the population will experience sexual assault in their lives. The President released a report that found that women and girls are the vast majority of victims, and that about 22 million women have been raped in their lifetime. It also looked at specific populations and found that marginalized communities experience higher rates of sexual violence: people with disabilities, the LGBT community, the homeless, prison inmates, and undocumented immigrants all fall into this category. Here in Connecticut, CONNACS serves over 7,000 people a year—women, boys, and girls—most of whom were assaulted by someone they knew.

Most of us are aware that the majority of sexual assault victims are women and girls, but I also wanted to share some troubling statistics about boys. 1 in 4 boys that are abused are under the age of 12 at the time of the assault; 1 in 7 are under the age of 6. Thanks to widely reported in the media high-profile scandals such as the Sandusky tragedy, and the ongoing cover-up of the Catholic Church, we are finally beginning to raise awareness about the commonality of very young boys being sexually assaulted. Fortunately there’s a silver lining, here: people are beginning to speak out as they never have before, and our communities are listening. Ms. Cordes noted a rise in rape occurrences according to national statistics indicating that more cases are being reported. This is due to an important change.  In 2012 the Department of Justice announced a major change in how it categorizes rape. Up until then, the definition hadn’t changed since the 1920′s: rape was defined only as vaginal penetration of a woman by a man. Now, the definition includes a wide spectrum of physical violation.

But this isn’t just a legislative battle. It is a cultural one. As Ms. Cordes put it, victims don’t just have to survive the attack; they have to survive the aftermath. An astonishing number are re-victimized and re-traumatized when they disclose their assault to loved ones. This isn’t because these family members are bad people, but because society has taught us to ask questions like: “Well how late were you out?” Or: “Why were you drinking?” Or: “Why do you wear outfits like that? That’s why it happened, you know.”

Responses like these can be deeply damaging to the survivor; moreover, the assumptions that they reveal are deeply inaccurate. As Ms. Cordes noted, perpetrators of sexual assault are attempting to assert their power and control. They use sex, but it isn’t about sex: it is about shame, humiliation, and control. Remember, the majority of instances are pre-meditated; sex offenders build relationships with their victims with the knowledge that this relationship will make their victim look complicit. And it only takes one poor response to re-traumatize a victim – and that trauma, if it is not addressed, will most likely follow them for decades.

If you are victim of sexual assault and are secretly struggling, please reach out. Even if the assault happened decades ago, you are absolutely entitled to support, and that support is out there! CONNSACS supports victims as they navigate the police station, the hospital, even the courtroom. Call one of the free, confidential hotlines, by dialing this number:

1 888 999 5545

To learn more, or to donate your time or money to this extremely important issue, visit

And to the many of us, who have experienced sexual violence, please remember that you are not alone, and you are not at fault. If you would like help, reach out! Laura Cordes and everyone at CONNSACS are here for you.

“Healing may not be so much about getting better, as about letting go of everything that isn’t you – all of the expectations, all of the beliefs – and becoming who you are.” – Rachel Naomi Remen

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How Can We Remain Connected to our Children in the Digital Age?

Posted on by Dr. Annie Abram

I began my radio show by playing Harry Chapin’s “Cats in the Cradle”, a song which my guest, Catherine Steiner-Adair, EdD, references in her book The Big Disconnect: Protecting Childhood and Family Relationships in the Digital Age. I asked Dr. Steiner-Adair – an internationally recognized clinical psychologist, school consultant and author – about the song, and she shared a story with me. A woman in one of her focus groups referenced the song while expressing her fear that her relationship to technology modeled unavailability to her children: she was always half-listening, always glued to a screen. She worried that when she and her husband aged, their children would, in turn, be unavailable to them.

This is one of the most important conundrums of our time. Technology has never before been such a presence in our daily lives, and we must think very carefully about how it affects our relationships. As Dr. Steiner-Adair so eloquently asks in her book, “The digital world is here to stay, but what are families losing with technology’s gain?”

Unfortunately, at this time, families are at risk for losing quite a lot. Many parents don’t understand how technology affects their daily interactions with their children. As Dr. Steiner-Adair noted, when we are interfacing with a screen, we are cognitively absorbed, and the part of our brain dedicated to empathy dims. If your child comes into the room and asks you something, you are much more likely to respond with a curt and agitated tone of voice if you are engaged with a screen because your brain is trying to accomplish something versus i.e. cooking or raking the yard. Dr. Steiner-Adair interviewed over 1,000 children, ages 4 – 18, about how this type of interaction with their parents makes them feel. She was shocked to discover that the reaction was very similar across the board, regardless of age – they even all used similar language: mad, sad, and lonely.

As Dr. Steiner-Adair pointed out, many of the behaviors we consider socially acceptable today—glancing at your phone at the dinner table, for example—would have been considered extremely rude ten years ago. But the world is now a different place. Technology is certainly not going away, so we have to make sure we use it to improve our relationships as opposed to depleting them. And right now, it looks like we as a society are falling victim to the “siren call” of technology; we are not mindful of how we engage with it or how this engagement affects us. Take early childhood development for example. One young child told Dr. Steiner-Adair that her favorite game was dress-up, then proceeded to describe an iPad game. The cognitive development of young children ages 0-5 absolutely relies on “deep play,” which is any play that engages a child’s imagination by prompting them to design their own rules. Deep play in groups is also extremely important: it teaches children how to interact with others in safe and rewarding ways. Children are spending less and less time engaged in deep-play, and their social-emotional development is suffering for it.

Luckily, at least three states have already included social-emotional intelligence in their core curriculums, and, in Dr. Steiner-Adair’s opinion, it is only a matter of time before social-emotional intelligence is recognized as a crucial skill that must be at the heart of our education system. Thanks to developments in the field of cognitive psychology, it is now undeniable that social-emotional intelligence is essential to success in a way that rivals math and literacy.

Technology, like any tool, can greatly help or hurt us: it all depends on how we use it. So let’s take a good look at how we operate as parents and as people, and decide if this is who we want to be.

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How to Help Girls Understand How Social Norms Can Affect Their Self Esteem

Posted on by Dr. Annie Abram

The problems faced by middle school girls struggling to look good and fit in are, in many ways, timeless. But the digital playground that our girls are navigating is brand new. To discuss the problems that parents and their pre-teen daughters are facing in this age of social media, I invited Dr. Tara Cousineau onto my radio show.

Dr. Cousineau is a clinical psychologist, self-esteem coach, and social entrepreneur who has many years of experience working with adolescent girls and women. She founded Moxie Moms coaching, which helps mothers of tween and teen girls build skills that strengthen their relationships with their daughters. She also received grants through the National Institute of Health to found BodiMojo Inc., which develops evidence-based and innovative solutions to help youth take control of their health by leveraging the digital playgrounds they reside in.

Adolescents are at a stage of development where they are naturally preoccupied with social comparison. But as Dr. Cousineau explained, social media has greatly heightened the time our kids spend comparing themselves to one another. Kids today are ranking, rating, and “liking” each other constantly. They have access to immediate and constant feedback as to where they fit in on the social ladder—and not just in an abstract sense. They’ve got numbers. How many followers do they have? How many likes they’ve received? How do we as parents—who are, in the words of Dr. Cousineau, “digital immigrants”– guide our children through this landscape that is so unfamiliar to us, and which they so fluidly and constantly navigate?

Dr. Cousineau very much emphasized that parents need to take responsibility for their children’s social media usage right from the start. Family phone plans make it so easy to just tack on that extra smartphone that your youngest child has been begging for, but we parents need to think carefully before we hand a smartphone to a ten-year-old. An online presence is a public persona that follows you for the rest of your life, and most ten-year-olds do not have the capacity to consider the implications of what they say; they react impulsively and emotionally. So think it all the way through before you give your child unlimited access to the Internet. Dr. Cousineau also advised that you create rules right from the start. How many hours a week is your child allowed on her device? Where is his phone kept? (The answer should probably not be his bedroom). Before you get your child a device, work together to set out a list of guidelines that you both feel good about. Make sure the rules and the consequences are clear. If you establish this right off the bat, it is much easier to maintain a conversation about your child’s media consumption as time goes on.

But what about parents for whom this is not an option? What if you have an adolescent girl who has had a phone for years, and with whom you don’t have a strong relationship? How can you instruct her about social media when she knows more than you do, and doesn’t want to hear anything you have to say anyway? Dr. Cousineau brought up an excellent strategy for dealing with this– a strategy we can all use, because most adolescent girls don’t want to hear from Mom. With her own daughter, Dr. Cousineau watched a ted talk by Dr. Caroline Helman, called The Sexy Lie. ( Without opening her mouth, she was able to give her daughter great information about the internalized sexual objectification of women. And her daughter thought it was pretty cool! Moral of the story? We can use media to our advantage.

But what about the many moms for whom sitting down to share a video is out of the question? Expand your network. Reach out to other family members, friends, or people in your community that could be good role models to your daughter. An aunt, a neighbor, or perhaps a girl only a few years older can help. Whatever you do, don’t give up! The rapidly evolving digital landscape is like the Wild West, and our daughters need guidance, whether they know it or not.

For more tips on responsible media consumption, visit:

For more information on Dr. Tara Cousineau’s work, visit her website:

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The Legacy of Violence and a Healing Curriculum for Children, Their Families and Communities.

Posted on by Dr. Annie Abram

Earlier this month, I took a trip to Northern Ireland to observe some of the early childhood development techniques that I’ve discussed previously on my radio show. My guest this week, Erin Forgay, was also on this trip, and agreed to discuss it with me last week on my radio show. Erin is a senior at Wheelock College in Boston, where she studies performing arts and education. Erin has extensive professional experience working with youth ranging from birth to age 18. She helps run a camp for children with special needs and she supervises youth and teen theater companies at the Springfield Jewish Community Center. She has over 10 years of experience in the theater world, and she is thinking of entering the field of drama therapy, particularly for kids in crisis.

During our time in Northern Ireland, we worked with Early Years, the largest organization in Northern Ireland working with and for young children, through their Media Initiative for Children, (MIFC). The goal of the Media Initiative is to help young children develop positive attitudes about physical, social, and cultural difference. Erin and fourteen of her peers were chosen from Wheelock College to go to Ireland to receive training by the Media Initiative and to observe classrooms in which the program is implemented. I was lucky enough to join them!

One shocking fact that the Media Initiative unearthed in their research is that children as young as three years old have already developed prejudices: they know the “good guys” from the “bad guys” in their community, based on information they’ve picked up from their family. The Media Initiative created 1 minute videos featuring persona dolls that demonstrate how people with differences can work together. The videos feature puppets like Jim, a Protestant; Tom, who is both Catholic and physically disabled (he has an eye-patch); as well as other dolls representing different minority groups in the community. The videos provide concrete scenarios that young children can process. For example, in one video, Jim’s baton gets stuck in a tree. Tom approaches and he is afraid, but then Tom helps him by using his hurley stick to get the baton down.

The Media Initiative has also been quite successful in providing programming for parents, which is of course crucial, since all sorts of prejudices and unprocessed emotions are passed on intergenerationally, particularly in nations that are healing from violent conflict.

Perhaps the most incredible thing that Erin and I witnessed in Northern Ireland was young children at play. Here in the U.S. we expect our kindergarteners to be acquiring skills like reading, writing, and arithmetic. According to the latest research in cognitive development, this is a major mistake. The brains of children that young are geared to learn through creative play: this is how you set the foundation for learning later on. Here in the U.S, children have forgotten how to play: they are easily bored without instruction and/or technology. They imitate rather than create. In Northern Ireland, however, we witnessed the beautiful sight of young children collaborating and creating naturally, without any prompting or instruction.

Let’s hope that programs like the Media Initiative find their way to the U.S.  We have our own prejudices and traumas to deal with, like bullying, gender issues, and our wars overseas.  We need to teach our children tolerance, and we need to let them play.

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Don’t Underestimate Battered Women

Posted on by Dr. Annie Abram

For those of us lucky enough to enjoy healthy partnerships, it can can be difficult to understand battered women. “Why doesn’t she just leave?” is a question I’ve often heard, and it reveals how deep the public misconception of battered women runs, even today. We tend to think of them as compliant, passive women with low self-esteem who are in denial about their situation, but this stereotype could not be farther from the truth.

To help deepen our understanding of—and empathy for—battered women, I invited Dr. Sherry Hamby onto my radio show. Dr. Hamby is a Research Professor of Psychology and Director of the Life Paths Research Program at the University of the South. She is also a founding editor of the APA journal Psychology of Violence, as well as the author or co-author of more than 100 works. Her most recent book is Battered Women’s Protective Strategies:  Stronger Than You Know (Oxford University Press, 2014). As a licensed clinical psychologist, Dr. Hamby has worked for more than 20 years on the problem of violence, and I was very eager to hear what she had to say about the public stereotype of battered women and how we can defeat it.

First of all, it is not just the general public that harbors this stereotype, says Dr. Hamby. She sees it in her very own field, as well as that of law enforcement. Some states discriminate against women who reunite with their batterers, which sends the message that their choice to remain in the relationship compromises their right to protection. This viewpoint—that battered women are self-harming, in denial, and somehow responsible for the violence they experience—is not an evidence-based perception at all, says Dr. Hamby. National statistics show that battered women seek out professional help from law enforcement at similar rates to other crime victims. 80-90% of battered women turn to friends and family for help. Think about how we as a society respond to life problems like depression, anxiety disorders, or mental illness. We take a therapeutic stance; we certainly don’t blame the sufferers. So why do we think differently of battered women?

Dr. Hamby has a few theories. First of all, there’s a “just world” phenomenon, a particularly American worldview, that says good things happen to good people. So, when something bad happens, we have a primitive, instinctual desire to find fault with the victim, because we want to believe they somehow have control of the situation. It is extremely uncomfortable to think about a really good person finding herself in an abusive partnership that she cannot escape. We want to believe that’s impossible. Another reason for this battered women stereotype is this pervasive, cross-cultural ideal of the “perfect victim” –a passive, weak, helpless woman in need of our assistance. Many agencies have used this “perfect victim” character to fundraise, or to raise awareness about domestic violence. But this stereotype is completely untrue.

What we do not understand about battered women is that they often face an impossible choice, which Dr. Hamby only fully understood after she herself had children. We talked a bit about this, because the way motherhood changes one’s worldview is a deep interest of mine. Some domestic violence shelters in the US do not admit male, adolescent children. Sometimes, they won’t even allow boys over the age of 6 (CT shelters accept women with their children). If you were advised to leave a relationship and to put your son in a homeless shelter, or foster care, or with family members that have no legal claim to the child and therefore cannot protect him from his father, would you do it? We criticize battered women for staying, when we should really be criticizing the system that puts them in these impossible situations.

What can we do? Dr. Hamby mentioned one great resource that I found extremely interesting: church communities. Many churches will help battered women move, or pay their electric bill, or find a place to stay, no questions asked. No forms, no waiting list, no bureaucracy to deal with: women can get immediate help with no strings attached. It is so strange to Dr. Hamby that this resource is not recognized in her field. Sure, there are some religious communities that encourage women to stay in terrible relationships, but one bad doctor does not prompt us to write off western medicine. So let’s not write off all religious communities simply because we don’t agree with some.

The bottom line is that there is no such thing as “the perfect victim.” We need to develop a much more holistic, complex perception of battered women—one that is based on strength. Let’s stop stop blaming victims and start encouraging survivors.

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Starting The Conversation With Young People About Healthy Relationships

Posted on by Dr. Annie Abram

If you were told that 1 in 3 adolescents die in car accidents, you would make sure that your child wore a seatbelt, wouldn’t you? Well, 1 in 3 young people will be involved in some kind of abusive relationship. Shocking, isn’t it? I was blown away by that statistic, which I learned from Darlene Kiyan when I interviewed her a couple weeks ago on my radio show. Ms. Kiyan is the executive director of Break The Cycle, the only organization that provides comprehensive dating abuse prevention programs exclusively for young people. I invited her to talk with us because I wanted to know more about how we as parents can support our children if they find themselves in abusive relationships, and how we can help prevent that from happening in the first place.

When we address this topic with our children, it is crucial that we speak from a place of complete support, openness and acceptance. If we seem to be judging or chastising them, they are likely to shut down. One way to begin the conversation is to open up about your own relationships. But Ms. Kiyan brought up an excellent point: there is one glaring difference between the relationships we experienced as young people and the ones our children are now experiencing. That difference is social media. Whether we like it or not, 72% of 8th and 9th graders nationwide are dating, and they are doing so in ways that we parents have never experienced, and often do not understand. Social media has transformed the way that young people relate to one another. So even if there has not been an increase in the amount of abuse occurring among young people, the ways that the abuse can occur have multiplied significantly. How do we begin to address an issue with our teenagers that is already extremely sensitive about a dating landscape that we hardly understand?

Well, one way is to start early. If you consciously work to create an open channel of communication with your child from an extremely early age, the channel is likely to remain open, regardless of the technology comes along. If your child knows from a very young age that you respect their emotions, they are likely to continue to open up. This sounds like a no-brainer, yet many parents unintentionally send the opposite message and set destructive patterns. Here’s an example Ms. Kiyan used: If your child comes up to you on the playground to complain that someone hit them, do not respond: “Oh, that just means they like you.” This sends the message that hitting is an acceptable way to express affection. Perhaps worse, this response does not support how your child is feeling. Teaching your child to trust and respect their own emotions is crucial in helping them develop positive relationships.

For those of us who are past the playground days and are parenting actual teenagers who may be at risk, Ms. Kiyan has some advice about beginning this conversation. You don’t even have to mention abuse; instead, talk about boundaries. How many texts a day from your partner feels good? How many feels like too many? Is your partner asking for your passwords, or telling you what to wear, or telling you who to hang out with? Does that feel good to you? Rather than telling your children what to do, remind them to tune into how they feel. Remind them to set boundaries that feel good to them.

What do you do if your child does find themselves in an abusive relationship? Again, it is crucial that you are open and supportive rather than controlling or chastising. It can be excruciatingly difficult to watch your child suffer any kind of abuse, but remember that they are the ones that must decide how to respond. The most dangerous time in an abusive relationship is during the break-up. Your child will know better than you when the time is right to make that move. Your job is to keep them as safe as possible, if and when they do decide to leave. And remember: they may not make that decision. Many people linger in abusive relationships because that seems safest. Whatever your child’s decision is, you must, above all else, support them.

Let’s be honest. It can be extremely difficult to talk with your teenager. Many teenagers want nothing to do with their parents, and would never dream of opening up to them about matters like these. If you are estranged from your child, or feel like there might be a problem that they won’t tell you about, encourage them to talk to their friends. Adolescents are much more likely to listen to their peers than adults. You can also encourage them to talk with a counselor—even a coach or a trusted mentor. The point is not whether or not they will talk to you. The point is making sure your child has as strong support system as possible.

Ms. Kiyan gave us some great resources that you can also share with your kids, and that I strongly encourage you to use if you or someone you love is experiencing any abuse, be it verbal, emotional, or physical.

Visit to learn more, and to chat with a peer advocate online.

Call 866 331 9474 or text “loveis” to 22522 talk to a professional confidentially.

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1.5 Million US High School Students Experience Physical Abuse From a Partner

Posted on by Dr. Annie Abram

Every year, nearly 1.5 million high school students nationwide experience physical abuse from a dating partner. 1 in 3 adolescents in the U.S. is a victim of physical, sexual, emotional, or verbal abuse from a dating partner, a number that far exceeds other types of youth violence. 1 in 10 high school students has been purposefully hit, slapped or hurt by a boyfriend or girlfriend. 1 in 4 high school girls have been victims of physical or sexual abuse. Approximately 70% of college students say they have been sexually coerced.

These are terrifying statistics. To learn more about why our teenagers are engaging in violent relationships, and how we can help them, I invited Ms. CarlLa Horton onto my blogtalk radio show.

Ms. Horton is the executive director of Hope’s Door, an organization in upper Westchester County that has been engaging with the issue of teen dating abuse since 1999. Back then, says Ms. Horton, her community did not even believe it was an issue. The national statistics, it was assumed, spoke to urban, impoverished areas, not to Westchester County. But when Hope’s Door surveyed the local teenagers, their findings mirrored the national statistics almost exactly: 1 in 5 girls were abused by partners in high school. 1 in 4 told no one, 1 in 4 told a parent, and 2 out of 3 told a peer. According to Ms. Horton, people continued to deny the problem until a string of high profile incidents in the area forced public opinion to shift. It is a well-established fact that domestic violence touches all communities, no matter where they happen to be located geographically or on the socio-economic scale. But when it comes to the teens in our own communities, the ones we remember from ballet class and Girl Scout camp, it is difficult to come to stomach the reality.

The reality is that 1 in 3 women worldwide will be physically or sexually abused in her lifetime. The reality is that our culture continues to perpetuate biases and stereotypes that demean women and girls, and these false beliefs cause intergenerational cycles of abuse in many households in our communities.

Hope’s Door reaches 7,000 to 8,000 teenagers annually, and is making some significant headway: The 25% of teens who would inform a parent back in 1999 is up to 42%, and those who would inform a peer are up to 86% from 60%. According to Ms. Horton, this is largely due to the STAR peer leadership program, which stands for Students Terminating Abusive Relationships. Since teenagers are much more likely to talk with each other than an adult, peer leadership programs have proven extremely effective.

That being said, we are far from solving the problem. As Ms. Horton pointed out, the numbers seem like good news, but they show that the majority of teenagers experiencing abuse do not go to an adult, and do not seek outside help. These programs have got to start much, much earlier, if we hope to eradicate the cultural forces at the heart of teen dating violence. In my opinion, we should begin teaching about healthy relationships in Pre-K, and should continue steadily into high school. Teaching our children how to build relationships based on equality, respect, and trust is absolutely essential to their wellbeing, and we as parents and community leaders need to advocate for programs in our public schools that address this.

One more thing: let’s bring men and boys to the table here. We teach our daughters many precautions against assault. Don’t walk alone at night. Never trust a stranger. Never put down your drink. But what do we teach our sons? We will never enjoy safe communities based on healthy relationships until men and women take equal responsibility in the effort to create them, and this means holding men and boys accountable.

If you or someone you know is experiencing teen dating violence, or any sort of domestic abuse, do not hesitate to call:


This hotline is multilingual, multi-cultural, free, and completely confidential. You can call it at any hour of the day to receive support. They will hear what your concerns and issues are, help you evaluate your options, and connect you with more support should you need it. They want to empower you, to help you regain the autonomy and freedom that you’ve lost. Remember: love should never hurt. And if you are being hurt, you are not alone. There are a lot of folks ready to help, many of them survivors themselves. All you have to do is reach out.

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Slavery and Human Trafficking – International Concern

Posted on by Dr. Annie Abram

This week on my blogtalk radio show, I wanted to continue learning about international sex trafficking, so I invited Helen Armstrong to talk with me about this and other forms of modern slavery. Ms. Armstrong has been involved in international human trafficking for many years. She has a degree in teaching from Harvard, and has worked as a teacher in Kenya for many years. Drawing on the experience of many frontline workers in the human trafficking industry, she wrote “Rebuilding Lives,” a manual on English and French, on the rehabilitation of those emerging from slavery around the world.

According to Ms. Armstrong, modern slavery is not too different from what it was 400 years ago. She defines slavery as profiting from another person over whom you have absolute control, who has been kidnapped and in some way violently coerced—physically or psychologically—into remaining in the situation. These criteria apply to all forms of slavery, of which there are many, but for the sake of our discussion, Ms. Armstrong said that sex trafficking and slavery are, basically, one and the same thing.

There are various ways that young women are forced or lured into sex trafficking, but here is one fact that everyone should know: 90% of the women who contacted the National Human Trafficking Resource Center here in the U.S. in 2013 were approached at or below age 13. By age 16, most had already been passed off to their third or fourth pimp. Many parents assume that children need not know about this issue until high school, if at all, which is simply not true. Ms. Armstrong strongly suggests that we speak to our girls about sex slavery as early as age 10 or 11, way before they hit puberty, because they are most vulnerable in middle school. This information helps shatter the misconception that sex slaves are somehow at fault. If a twelve-year-old is approached by a pimp outside of her school, what, exactly, did she do wrong? Pimps target vulnerable young girls who come from tough living situations and are eager to get out. Ms. Armstrong identified two characteristics of sex trafficking that are true the world over: false promises and violence. These young girls are promised a good job, an education, sometimes love, and they are so young that they lack the cognitive skills to understand the risk they are taking. These children are victims of a heinous crime, which also happens to also be a 32 billion dollar a year industry—second largest in the world, behind illegal drugs.

There are other forms of slavery occurring right here in our own communities. Of the 72,000 calls that came into the National Human Trafficking Resource Center in 2013, 27% of them were domestic workers isolated in households. Most of them were women who were not only trapped but also vulnerable to sexual exploitation. You can find slaves in America working in the construction, agriculture, and restaurant industries. Ms. Armstrong and I also discussed the permeable barrier between slavery and domestic violence: many women who suffer domestic abuse are, for all intents and purposes, slaves themselves. They have no control over their lives—no communication with the outside world or access to public places without their husbands.

There is some good news. We are closer than ever before to ending slavery. No economy depends on slavery, and it is illegal by universal consensus. The problem is that the laws are not enforced: governments turn a blind eye because those profiting from the industry are much more powerful than those enslaved by it. We can help end slavery simply by getting involved in local politics. To find out how to take action here in the United States, visit, where we put out a summary every two weeks of state legislation that’s being debated.

Another tactic that Ms. Armstrong mentioned, which has been specifically helpful in nations like India where entire communities are enslaved, is to get the survivors to organize, to coalesce. Together, their voice has proved to have an impact. To learn more about international trafficking and to become an advocate for slaves worldwide, visit

And if you or someone you know needs help, please call the Polaris Project right away: 1 888 3737 888

Let’s all help end slavery once and for all.

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Human Trafficking of Young People (12-16) – Today’s Slavery

Posted on by Dr. Annie Abram

Slavery exists in the United States. In fact, it is thriving. Human trafficking and prostitution is a multi-billion dollar industry, second in revenue to illegal drugs, fueled by men who buy and sell the bodies of women and children. I invited Ms. Vednita Carter onto my blogtalk radio show to educate us about this issue. Ms. Carter is the founder and executive director of Breaking Free, an organization based in Minnesota that helps 400-500 women every year escape the horrific lifestyle of prostitution.

Our discussion shocked me. I had no idea how uninformed I was about an issue that is happening in my own community. Ms. Carter spoke about the misrepresentation of the industry that the media perpetuates with films such as Pretty Woman. Prostitution is not a prosperous lifestyle. It does not involve making good money or making love to kind, wealthy men.

Practically 100% of the women that Ms. Carter works with are chemically dependent. Ms. Carter sticks with the numbers that represent the women that she interacts personally, because there is a dearth of research on a national level, but here are some numbers that she can confirm: the average age of young girls being trafficked into the US is 12-14 years old. The youngest child that Ms. Carter is currently working with is 12 years old. According to Ms. Carter, the FBI has confirmed that young women who run away from home have an extremely high risk of being kidnapped or lured into prostitution within 24-48 hours of their disappearance. The cultural stereotype paints a “pimp” as a criminal in a slum, but according to Ms. Carter, this is completely inaccurate. Traffickers and pimps will prowl places that vulnerable young women are likely to appear alone.

One story Ms. Carter shared with us was about 2 sixteen year old girls who befriended a pair of young men—as young as 19 or 20—at the mall. They had lunch with them in the food court, were drugged, and woke up in a motel room, where they were forced to have sex with all the men that entered the room. One of them begged each man who came in to contact her family. She was trapped there for 6 months before someone finally called the authorities, who found fourteen young girls trapped at this motel.

100% of the women that Ms. Carter works with suffer from PTSD. Over half of them are homeless, and have nowhere to live except with their trafficker, pimp, or trick, who charge them for food and a place to sleep. It is difficult to prosecute pimps, because their prostitutes are too terrified to provide evidence. When she has experienced the violence of which her captor is capable—why would a woman risk her own life, as well as those of her loved ones, to come forth with evidence when there is no guarantee that he will be charged and no protection from his allies?

Another real shock to me was how commonly prostitution occurs at events like the Super Bowl. Any massive gathering of men—a doctor’s convention was one example Ms. Carter cited—attracts pimps, and this gets to the heart of the problem: we consider the pimp the criminal, but what about the “John?” As long as there is demand for prostitutes, the industry will thrive. Who are these men who purchase young girls for sex? Should they not be considered criminal? Prostitution is still considered “the oldest profession” in the world In reality, it is the oldest form of oppression. In the United States, prostitutes are expected to serve, on average, 15-20 men a day. Internationally, it is closer to 40. That is not a career. That is torture.

Immense progress has been made since Ms. Carter founded her organization in the ’80′s, when she could not even get churches to open their doors to these women. Now, she works with legislators. But there is a long way to go, specifically in the field of public awareness. Organizations like Breaking Free are trying to speak in schools so they can educate young girls about the dangers they face, but most school systems decline because often parents think that sex trafficking is not something their own daughters need worry about. They are very wrong. Let’s teach our daughters never to trust strange men, no matter how smooth they are. Just as importantly, let’s teach our sons to respect women. Purchasing a woman’s body is not acceptable. It is a heinous, violent crime.

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Eating Disorders – The Most Deadly Mental Illness

Posted on by Dr. Annie Abram

Few people know that eating disorders have the highest mortality rate out of all psychiatric disorders. Since many people with eating disorders die of related issues like organ failure or a heart attack, the actual statistic is almost certainly higher than the 20% mortality rate currently cited for anorexia nervosa. We should all be alarmed by this fact. Eating disorders are pervasive in our society, and treatment is extremely complex and difficult. I have experienced this firsthand in my own practice, and I am extremely interested in learning about what progress we have made in determining what causes these illnesses and how to best treat them. So, I invited Jamie D. Shumake, LMHC, the clinical supervisor at The Renfrew Center in Old Greenwich, CT, on my blogtalk radio show. The Renfrew Center is the largest and oldest eating disorder treatment program in the country, and its nationwide network of centers treats 1500-2000 patients at any given time.

My own experience is that many times, those seeking rehabilitation from an eating disorder do not actually want contact. They do not want to give up their symptoms because they are a protective mechanism that the patient very much needs. Family dynamics, societal expectations, peer groups—the potential sources of stress that trigger a patient’s protective instincts are numerous, and often multi-faceted. So many patients that show up for treatment don’t actually want it. How do you treat someone who doesn’t want treatment?

Mr. Shumake concurred that many patients do not actually want to be cured. He believes that eating disorders are among the most difficult psychiatric illnesses to treat, and establishing a therapeutic relationship with the patient has got to be the primary goal. Otherwise, it is extremely difficult to engage with the patient, because the disorder represents their ability to control a certain aspect of their life, and sending the message: “we will attack what protects you” is going to make any patient reluctant.

Over the past thirty years, a great deal of progress has been made in understanding the genesis of this disease. For example, anorexia nervosa and bulimia are now seen and treated as completely separate disorders. It is hard to believe that the first diagnosis occurred in 1684, and here we are in 2014, and still there is no one protocol, no one treatment, that has been proven most effective. Why? Well, Mr. Shumake said that the research points toward cognitive behavioral intervention and the Maudsley model—a family-centered model developed in the UK upon which The Renfrew Center protocol is based. Of course, it is very challenging, time-consuming, and expensive to conduct the type of robust, long-term research on which we could base treatment outcomes. Moreover, as the Renfew Center demonstrates, effective treatment must be greatly tailored to the individual.

The Renfew Center takes a comprehensive, family-based approach, because–like all psychiatric illnesses–eating disorders affect not just the individual, but also those close to them. Contrary to popular belief, when a patient recovers, a family’s equilibrium is threatened: the patient is often a scapegoat, their disease a great source of shame. Once treatment is well underway, family members must re-define their roles. That is why the Renfew Center treats whole families. They provide education, therapy, and a support system that lasts the rest of their lives (the Renfew Center has a very active alumni network). In the meantime, a team of specialists work together to create a comprehensive therapeutic intervention for the individual, including (but not limited to) cognitive therapy to help uncover the problems underneath the food issues and a nutritionist to educate the patient away from destructive stereotypes surrounding nutrition.

As Mr. Shumake pointed out, mental health is emerging from the shadows. We now see public service announcements about depression and schizophrenia. Hopefully eating disorders will be next.  As the #1 killer among psychiatric illness, and it deserves our attention!

If you or a loved one may have an eating disorder and would like to seek further information, Mr. Shumake urges you to call 1 800 RENFREW at any time, where you can talk it over with an expert.

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