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The Bystander Borderline

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This powerpoint was used during my graduating presentation: "With 1 out of every 4 women experiencing domestic violence or sexual assault in their lifetime, with these crimes rising at a rate 4 times …

This powerpoint was used during my graduating presentation: "With 1 out of every 4 women experiencing domestic violence or sexual assault in their lifetime, with these crimes rising at a rate 4 times faster than other crimes, with the U.S. political environment rising to the effect of the infamous “War on Women,” we must ask ourselves at what point do we choose to stop being a bystander and actively engage in the traumatic events that are being perpetrated against the women we care about? Throughout this workshop, we will work to identify the ways in which women who have endured traumatic experience continue to endure oppression through judicial, social, and clinical reinforcements and how this stunts their healing."

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  • 1. THE BYSTANDER BORDERLINE
  • 2. The materials discussed during this presentation will discuss situations in which potentially graphic sexual and domestic violence has occurred and the situations and societal responses may be triggering or uncomfortable. Please feel free to leave the room whenever you please in order to take care of yourself best. Some of the best trauma advocacy is self-care. TRIGGER WARNING
  • 3. What do you mean by the “Bystander Borderline?” This presentation will discuss how our society encourages and tolerates bystander effect and how this impacts trauma advocacy, trauma narratives, and clinical/social/judicial approaches towards trauma and trauma survivors. Notably, a high percentage of individuals who have PTSD (Post Traumatic Stress Disorder), Bipolar Disorder, and Borderline Personality Disorder are frequently those who have endured trauma at an early age. BREAKING DOWN “THE BYSTANDER BORDERLINE”
  • 4. What is the Bystander Effect? - Bystander Effect is the phenomena wherein the more people that are present in a social situation, the less likely one individual is to help another individual in distress. - The most well-known example is the incident that occurred with Kitty Genovese - Bystander Effect TV example - Recent example of Bystander Effect BYSTANDER EFFECT
  • 5. - The Bystander Effect is amplified by myths we have surrounding sexual assault and domestic violence and expectations of gender roles. - Some myths and expectations include: Women are emotional. Women are illogical. Women are crazy. If women argue with you, they need to get a sense of humor. If women argue with you, they‟re on their period. If she‟s wearing a short skirt, drinking too much, being too challenging, going to a party alone, leaving her drink unattended, etc. etc. etc.: she deserved the trauma that happens to her. Most sexual assault incidents happen to individuals by strangers. If you consented at the beginning, you consented. If you‟re in a consensual relationship, you consented. If you didn‟t say „no,‟ you consented. If you didn‟t fight back, you consented. All women crave relationships. All women want to get married. All women want to have children. WHAT DOES THIS MEAN FOR CRIMES AGAINST WOMEN?
  • 6. Some examples of how these myths play out: - “Eight factors tilt a woman towards the „vamp‟ identity: If she knows her assailant; if no weapon is used; if she is of the same race, class, or ethnic group as the assailant; if she is young; if she is considered pretty; and if she is in any way deviates from the traditional housewife-mother role” (Tanenbaum 127). “If a victim is calm in court, she is seen as not having suffered enough, which indicates she is not a genuine victim; if she is sobbing and frightened, she is seen as hysterical, unstable, and thus unreliable” (Benedict 122-123). -“Other studies conducted in 1987 found that victims are still widely blamed for inviting rape, while perpetrators are seen as lustful men driven beyond endurance.” (Benedict 13). -“A telephone survey of 500 American adults taken for Time magazine in May 1991, found that 53 percent of adults over age 50 and 31 percent of adults between thirty-five and forty believe that a woman is to be blamed for her rape if she dresses provocatively” (Benedict 15). - “The language we use to talk about violence is quite literally being taken away from us. In 2004, a Nebraska judge barred the word „rape‟ from the trial of a man accused of... well, rape. The judge ruled that the language would be too prejudicial. The victim instead would have to use words like „intercourse‟ and „sex‟ to describe her act” (Valenti 163). WHAT DOES THIS MEAN FOR CRIMES AGAINST WOMEN?
  • 7. -“A year earlier (2006), in Maryland, a state court ruled that once a woman consents to sex, she can‟t change her mind. Not if it hurts, not if her partner has become violent, not if she simply wants to stop. If she says yes once, nothing that happens afterwards is [rape].” (Valenti 146). - “Similarly, a judge in Philadelphia ruled that a sex worker whom multiple men had raped at gunpoint hadn‟t been raped at all – she‟d just been robbed” (Valenti 156). WHAT DOES THIS MEAN FOR CRIMES AGAINST WOMEN?
  • 8. - 1 in 4 women in their life will experience domestic violence. 1 in 4 women will experience sexual assault in their life. - Crimes against women are rising four times faster than any other crime. (DeBecker) - -54% of rapes are not reported to the police. (RAINN) - -97% of rapists will never spend a day in jail. (RAINN) - Victims of sexual assault are: 3 times more likely to suffer from depression, 6 times more likely to suffer from PTSD, 13 times more likely to abuse alcohol, 26 times more likely to abuse drugs, 4 times more likely to contemplate suicide. (RAINN) - Only approximately one-quarter of all physical assaults, one-fifth of all rapes, and one-half of all stalkings perpetuated against females by intimate partners are reported to the police. (NCADV) - There are 16,800 homicides and $2.2 million (medically treated) injuries due to intimate partner violence annually, which costs $37 billion (Less than one-fifth of victims reporting an injury from intimate partner violence sought medical treatment following the injury). THE STATISTICS
  • 9. - “Gaslighting is a type of projective identification in which an individual (or group of individuals) attempt to influence the mental functioning of a second individual by causing the latter to doubt the validity of his or her judgments, perceptions, and/or reality testing in order that the victim will more readily submit his will and person to the victimizer” (Dorpat 6). -“In order to escape accountability for his crimes, the perpetrator does everything in his power to promote forgetting. Secrecy and silence are the perpetrator‟s first line of defense. If secrecy fails, the perpetrator attacks the credibility of his victim. If he cannot silence her absolutely, he tries to make sure that no one listens. To this end, he marshals an impressive array of arguments, from the most blatant denial to the most sophisticated and elegant rationalization. After every atrocity one can expect to hear the same predictable apologies: it never happened; the victim lies; the victim exaggerates; the victim brought it upon herself; and in any case it is time to forget and move on. The more powerful the perpetrator, the greater is his prerogative to name and define reality, and the more completely his arguments prevail”(Herman 8). GASLIGHTING AND DENIAL
  • 10. I‟ve presented these facts about the frequency of violence for a reason: to increase the likelihood that you will believe it is at least possible that you or someone you care for will be a victim at some time. The belief is a key element in recognizing when you are in the presence of danger. That belief balances denial, the powerful and cunning enemy of successful prediction. Even having learned these facts of life and death, some readers will still compartmentalize the hazards in order to exclude themselves: „Sure, there‟s a lot of violence, but that‟s in the inner city‟; „Yeah, a lot of women are battered, but I‟m not in a relationship now‟; „Violence is a problem for younger people, or older people.‟; „You‟re only at risk if you‟re out late at night‟; „People bring it on themselves,‟ and on and on. Americans are experts at denial, a choir whose song could be „Things Like That Don‟t Happen in This Neighborhood.‟ (DeBecker 9-10) GASLIGHTING AND DENIAL
  • 11. - BPD is manifested by a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: - 1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5). - 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.” - 3. Identity disturbance: markedly and persistently unstable self-image or sense of self. - 4. Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5). - 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. - 6. Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). - 7. Chronic feelings of emptiness. - 8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights). - 9. Transient, stress-related paranoid ideation or severe dissociative symptoms. WHAT IS BORDERLINE PERSONALITY DISORDER?
  • 12. Diagnostic criteria for PTSD include a history of exposure to a traumatic event that meets specific stipulations and symptoms from each of four symptom clusters: intrusion, avoidance, negative alteration in cognitions and mood, and alterations in arousal and reactivity. The sixth criterion concerns duration of symptoms; the seventh assesses functioning; and, the eighth criterion clarifies symptoms as not attributable to a substance of co-occurring medical condition. -Criterion A: stressor. The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: 1. Direct exposure. 2. Witnessing, in person. 3. Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental. 4. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties. This does not include indirect non-professional exposure through electronic media, television, movies, or pictures. -Criterion B: intrusion symptoms. The traumatic event is persistently re-experienced in the following way(s): 1. Recurrent, involuntary, and intrusive memories. 2. Traumatic nightmares. 3. Dissociative reactions (e.g. flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. -Criterion C: avoidance. Persistent effortful avoidance of distressing trauma-related stimuli after the event. 1. Trauma related thoughts or feelings. Trauma-related external reminds (e.g. people, places, conversations, activities, objects, or situations). WHAT IS PTSD?
  • 13. -Criterion D: negative alterations in cognitions and mood. Negative alterations in cognitions and mood that began or worsened after the traumatic event: 1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol or drugs). 2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world. 3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences. 4. Persistent negative trauma-related emotions (e.g. fear, horror, anger, guilt or shame). 5. Markedly diminished interest in (pre-traumatic) significant activities. 6. Feeling alienated from others (e.g. detachment or estrangement). 7. Constricted affect: persistent inability to experience positive emotions. -Criterion E: Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: 1. Irritable or aggressive behavior. 2. Self- destructive or reckless behavior. 3 Hypervigilance. 4. Exaggerated startle response. 5. Problems in concentration. 6. Sleep disturbance. - Criterion F: duration. Persistence of symptoms (in Criteria B, C, D, and E) for more than one month. WHAT IS PTSD? CONT.
  • 14. 1. BPD: 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.” PTSD: -Criterion C: avoidance. Persistent effortful avoidance of distressing trauma- related stimuli after the event. 1. Trauma related thoughts or feelings. Trauma- related external reminds (e.g. people, places, conversations, activities, objects, or situations). 2. BPD: 4. Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5). PTSD: -Criterion E: Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: 1. Irritable or aggressive behavior. 2. Self- destructive or reckless behavior. 3 Hypervigilance. 4. Exaggerated startle response. 5. Problems in concentration. 6. Sleep disturbance. WHERE’S THE OVERLAP?
  • 15. 3. BPD: 3. Identity disturbance: markedly and persistently unstable self-image or sense of self. • - 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. - 6. Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). - 7. Chronic feelings of emptiness. - 8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights). - 9. Transient, stress-related paranoid ideation or severe dissociative symptoms. PTSD: Criterion D: negative alterations in cognitions and mood. Negative alterations in cognitions and mood that began or worsened after the traumatic event: 1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol or drugs). 2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world. 3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences. 4. Persistent negative trauma-related emotions (e.g. fear, horror, anger, guilt or shame). 5. Markedly diminished interest in (pre-traumatic) significant activities. 6. Feeling alienated from others (e.g. detachment or estrangement). 7. Constricted affect: persistent inability to experience positive emotions -Criterion E: Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: 1. Irritable or aggressive behavior. 2. Self-destructive or reckless behavior. 3 Hypervigilance. 4. Exaggerated startle response. 5. Problems in concentration. 6. Sleep disturbance. KEEP IN MIND YOU ONLY NEED 5/9 CRITERIA LISTED, MET, TO HAVE BPD. WHERE’S THE OVERLAP?
  • 16. - “The BPD category grew out of the original diagnosis of hysteria, which as a medical diagnoses dates back to the early 1800s. Originally, this term was used when the clinician was unsure of the correct diagnosis, because the client manifested a mixture of neurotic and psychotic, and thus the term borderline came into the diagnostic lexicon (Beck & Freeman, 1990). The DSM-IV reports that the lifetime prevalence rates for PTSD range from 1% to 14% (APA, 1994). Sperry and Mosak (1993) noted, „the borderline personality disorder is becoming one of the most common Axis II presentations, seen in both the public sector and in private practice‟ (pp. 356-358). Beck and Freeman summed up BPD in the following hypothetical dialogue: SUPERVISOR: Why are you having trouble with Mr. Schultz? THERAPIST: Because he‟s borderline. SUPERVISOR: Why do you consider him borderline? THERAPIST: Because I‟m having so much trouble with him (p. 178)” (Hodges) Despite BPD‟s prominence as one of the most widely researched disorders, there is no consistent proof of either its reliability or validity (Becker, 1997; Francis & Widigen, 1987). Furthermore, it is a diagnosis that has been applied to women at a rate 7 times greater than for men.” (Hodges) - “A current perspective is that BPD is actually a chronic form of PTSD that has become integrated into the personality framework (Landecker, 1992; Zimmerman & Mattia, 1999). This theory maintains that prolonged and repeated stress can result in the development of behavior patterns that are maladaptive but that cannot be readily distinguished from personality traits (Kroll, 1993). Thus, many women who have been exposed to chronic trauma are incorrectly misdiagnosed as having personality disorders, particularly BPD” (Hodges). WHAT IMPACT DOES THIS HAVE?
  • 17. At its heart, the question of whether the sane can be distinguished from the insane (and whether degrees of insanity can be distinguished from each other) is a simple matter: do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observers find them? From Blueler, through Kretchmer, through the formulators of the recently revised Diagnostic and Statistical Manual of the American Psychiatric Association, the belief has been strong that patients present symptoms, that those symptoms can be categorized, and implicitly, that the sane are distinguishable from the insane. More recently, however, this belief has been questioned. Based in part on theoretical and anthropological considerations, but also on philosophical, legal, and therapeutic ones, the view has grown that psychological categorization of mental illness is useless at best and downright harmful, mislead, and pejorative at worst. Psychiatrist diagnoses, in this view, are in the minds of the observers and are not valid summaries of characteristics displayed by the observed (Rosenhan 380). CONCLUSION