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LLP054: Learning to define Sexual Assault with Rhodena Mesadieu LCSW

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In medicine being able to accurately establish your diagnosis can be the difference between life or death. If I don't correctly diagnose my patient, then I eventually incorrectly give the wrong treatment and ultimately can cause harm which I may not have a second chance to correct. At a time where sexual assault has almost become an everyday topic I knew that it would be important for the Lunch and Learn community to understand what is sexual assault and why it is so important to know the difference.

On today's episode we have Rhodena Mesadieu, a licensed clinical social worker and we discuss the importance of defining the term Sexual Assault. Rhodena is  a trauma specialist who works in facilitating survivors' healing journey from sexual abuse in adult women and young girls.


In this episode you will learn:

  • What does sexual assault actually mean?
  • What are some signs and symptoms I shouldn't miss as a physician 
  • What does consent really mean
  • Interesting statistics associated with sexual assault and abuse
  • What to do when you are ready to admit that you have been sexually abused

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Transcript of the show – https://www.drpierresblog.com/54notes

M. Davis-Pierre: Thanks for listening to the Lunch and Learn with Dr. Berry, here to help educate, motivate, and put you on the right path to take control of your health through weekly discussions on topics in the medical field, public health arena, and in your community. And now your host, Dr. Berry.

Dr. Berry:                                Hey it's Dr. Berry here, board certified internist, host of the Lunch and Learn, and today's episode is going to be a great one. We have Rhodena Mesadieu. She is a licensed clinical social worker. She's going to be talking to us about sexual assault, how to really define it and really get to the nitty gritty of how it affects everybody, male and female. I really want to stress the male part, because I think that sometimes gets lost in this discussion.

Dr. Berry:                                Unless you've been under a rock, you know sexual assault and allegations and sexual abuse have been all over TV, radio, Twitter, Instagram, Facebook; wherever you consume your media, there has been some discussion one way or the other regarding sexual assault, so I wanted to bring on a special guest who's an expert in this discussion to help me along and help the Lunch and Learn community, so stay tuned for an amazing episode like always. If you want the show notes, head over to DrPierresBlog.com/LLP054 and in the show notes, I'm also having a link for a transcript. We're actually going to be providing a transcript for you guys for this episode, so get ready and get set for another amazing episode here with the Lunch and Learn with Dr. Berry.

Dr. Berry:                                First of all, thank you for joining another episode of the Lunch and Learn with Dr. Berry. Like I alluded to earlier last week, we have a special guest for a special topic. Unless you've been sleeping under a rock and haven't read a magazine, haven't turned on your TV, this is a topic that's been going across the board. There's really not an industry that is being affected primarily from the topic of sexual assault, sexual trauma. Like you know, as an internist, I know a lot about a lot. But when I don't know something, I always like to bring the big guns. I always like to bring the expert on.

Dr. Berry:                                Today, I have one of those experts in the building. Lunch and Learn community, first of all, I want you to give a nice round of applause wherever you're listening to this episode, to Rhodena Mesadieu. She is a licensed clinical social worker whose specialty is trauma-focused cognitive behavioral therapy. But again, I'm not even going to butcher her bio. Rhodena, please tell the audience, tell the people listening who you are and why I am in such awe of why you're on the episode this week.

  1. Mesadieu: Thank you, Dr. Berry. You are so kind. As you said, my name is Rhodena Mesadieu. I am a licensed clinical social worker, so I provide psychotherapy at a practice called Soul Spring Counseling in Palm Beach Gardens, and I am the trauma specialist there, specifically sexual abuse. I love that you're not only mentioning sexual assault, but you also mentioned sexual trauma, because that is more specific towards the different types of trauma that happen sexually rather than just the assault portion. I'm so excited to have this conversation and even amongst the climate right now, I'm very excited that we're opening up this conversation for everyone.

Dr. Berry:                                I got a lot of questions. I have a lot of user questions that were fed to me that they wanted me to ask you. But I think I wanted to start off right in the beginning, because I'll admit again, I'm an internist, but I'm naïve to some subjects. This is really one of them. Can you give us a definition or what does it mean to be sexually assaulted? What is sexual assault? Because in this day and age, I'm not entirely sure I get the one picture. When I see one situation, they are calling that sexual assault, and I see something on a different spectrum, they're also calling that sexual assault, and I'm not sure … Again, and I'm naïve to the subject. If it's all under one umbrella, or is there certain levels of degree that I'm just missing?

  1. Mesadieu: Yeah, so that is a very, very good question. Sexual assault would be more of the general term of the action. When you're talking about being in a place where someone takes an action against you, that would be considered assault. For example, in domestic violence situations. If you are hit by your spouse, that would be considered an assault or a battery but the pattern of the things that happen in their relationship is considered domestic violence.
  2. Mesadieu: Sexual assault is the same way. It's the actual action of violating someone else, and then sexual abuse and sexual trauma is also a general term that falls into specific categories of abuse. Sexual harm can be subtle and it can be extensive, like you're bringing up with the different examples. It can go from being groped in the cafeteria line to rape without consent, to unwanted pattern of being exploited sexually. There's just such a wide gamut of things that happen in regards to sexual assault, so I think the more term that could be inclusive here could be sexual harm or sexual trauma.

Dr. Berry:                                As the expert in your field, do you find when people who clearly can't really grasp a term fully, when they just kind of use that sexual assault … When they kind of use it willy nilly, do you find harm in that? Is that something that we just need to kind of learn to educate ourselves on? How would you … What are your feelings, especially you being in the field?

  1. Mesadieu: Yeah. I don't know if I would say that it causes harm. It could cause harm. For example, sexual assault could mean a physical action toward someone, right? And if someone said a word to me that I felt like, like harassment, for example, sexual harassment, that brings a different language to what I'm experiencing. So the different words that you use does bring a language.
  2. Mesadieu: There's a difference between domestic violence and intimate partner violence that includes sexual content. It makes more of a specificness, and I would say that sexual assault is a general word. I don't think it would be harmful unless you're communicating something that's at a lesser degree that could cause negative consequences for that person. But for the general consensus for everyone, I would say sexual assault is a pretty common term in sexual abuse or sexual trauma.

Dr. Berry:                                Lunch and Learn community, I want to tell you again; you're going to be extremely very educated by this expert here. Again, I'm excited to have her on the show this week. Again, it's only been five, 10 minutes, and I'm already adjusting the mindset of what it even means to be sexually assaulted; to be sexually abused; sexually harassed. There were terms that even I as a physician just kind of lump together. If anyone in the field should be able to recognize the subtle differences, and sometimes really not so subtle differences, it should be those in the healthcare field.

Dr. Berry:                                If those in the healthcare field like myself have trouble separating the terms, I can only imagine what our quote unquote “laymen” may be experiencing, especially when they turn on the TV and they see all the women and men coming out. Almost seems like droves and telling their story, just kind of getting filed under that one umbrella. I definitely don't want us to downplay the importance of the definition, because again, with definition comes power. If we define it like we're supposed to define it, it allows our mind to really embrace when a lot of … Again, I don't want to … I'm not sure if victim is the right term, and please correct me if I'm wrong, but a lot of the victims … the people who come forward in their stories, it allows them to empower themselves as well.

  1. Mesadieu: Yeah. And you know, legally, there's a huge range of ways to communicate a sexual assault or a sexual trauma. Definitions of rape and obtaining consent vary based on your state laws. Everyone's confusion or being able to lump it into one word, I think that goes along just with society and also with laws. People don't really know how you're going to define it unless you're looking at the statute that says, “This is exactly what it means.”
  2. Mesadieu: I mean, sexual battery in the statutes means oral, anal, or vaginal penetration by union with or the sexual organ of another. Anal or vaginal penetration of another or by another object. So that is just a portion of sexual assault or sexual harassment that we're talking about. There's harassment that don't involve any body parts actually touching each other. Even with the laws, it doesn't fully define all the aspects of sexual assault, and it's left to ambiguity until we have these words that allow us to talk about the different forms and the different crimes within that context. Like sexual assault, child sexual abuse, incest is a different aspect of sexual abuse and sexual assault that provides a different military action. Prisoner rape. Those are all different types of sexual assaults that occur.

Dr. Berry:                                Wow. Wow, that's … Again, thank you for educating us. As someone in the health field who may run into or encounter someone who has experienced a sexual assault or sexual-type trauma, because I'm not fully trained in that field, what are some things that I should be looking for? What are some I guess common characteristics or mannerisms or symptoms that they would experience that would maybe help me clue me in to maybe those are questions I should be asking?

  1. Mesadieu: Absolutely. First and foremost, I want to say that these are factors that are coming into play. I also say, never assume to know someone's story. What I'm going to mention is, it's not all inclusive, but they are things that have been related or have a high correlation to victims of any type of sexual trauma. I think a lot of the times, you'll see anxiety and depression. People come in to their physicians a lot for anxiety and depression, and one of the things that I would say to look at there are, is there any underlying trauma?
  2. Mesadieu: Sexual assault is highly correlated to chronic and pain, especially in the [abdomal 00:11:40] or pelvic pain. Low pain threshold, anxiety, depression. If they're not taking care of themself. If you're noticing any self-neglect. Eating disorders have been attributed to childhood sexual abuse, so even in children, wanting to see any of those signs. Are they sensitive to touch? Do they react differently when I touch them in certain areas? That can be a factor there. Is there any alcohol or illicit drugs, or is there any associations between sexual activities? When you're talking about intimacy issues, is there any difficultly with getting aroused or being hyper aroused, or any pain during sex? All of those are associated. If they're a high intimate sexual partner when you're doing your screening or you're gaining your history. Any HIV, any STDs.
  3. Mesadieu: Now, again, that's not saying every person who experiences this has been actually abused. However, these are factors that we know when you're seeing a lot of this, that that would be a question to ask. Fibromyalgia has a huge high correlation with sexual abuse. It goes up to 80 to 90% of folks that they've tested who had fibromyalgia had some type of abuse, physical and sexual abuse, in their past. That manifests itself through fibromyalgia. It's not a causation, but there is a high correlation of people who have that in their past history.
  4. Mesadieu: So I think noticing pain, anxiety, because post-traumatic stress disorder is an anxiety disorder. They may not know because something that happened to me 10, 20, 30 years ago that they may not even mention, they're coming in for anxiety or depression and just seeing are there any underlying abuse here that's happening?

Dr. Berry:                                And for those who maybe that are unfamiliar with fibromyalgia, from an internist's standpoint, fibromyalgia is one of those diagnosis that we consider a wastebasket diagnosis. Reason being is that you have your patients who come in with chronic, excruciating pain and you may do a million dollar workup and not really find a reason why they're in pain. You check for everything. Arthritis, infection. Everything under the sun to try to see why is this patient in front of me having so much pain? And I can tell you as an internist, I will … and as a physician in general, we are not the best. Again, I think I'm very fortunate. In close proximity, I have a therapist who likes to talk. And she stresses that I should like to talk.

Dr. Berry:                                But I'll be honest. As a physician, that's not our forte. We tend not to talk a lot about the stuff we can't see. So because we can't physically see on the blood test, because we can't physically see on an imaging, we say we don't know. And we're not the best at trying to get down to the bottom of maybe there's another reason why she's having this pain and discomfort. In medical school, sexual trauma, sexual abuse isn't one of the questions we tend to ask when we have pain. It just isn't.

  1. Mesadieu: Right. Right.

Dr. Berry:                                There's a laundry list of questions we ask, and I'm not sure if it's a factor of physicians don't want to go down that rabbit hole because they don't know, or they're just neglectfully saying, “I'm not even going to touch that,” which is very interesting. Again, we could probably talk on that for quite some time, what physicians should be doing

  1. Mesadieu: Right, and also, counteracting the studies that are happening. Studies that are happening in the mental health world, I'm not going to share the process of that completely coming over into the physician studies in the physician's world in counteracting how our mental health and our physical health come in together. I think it's more of having these conversations to say, “There are studies that have been made that are linked to specific past history.” Physical abuse percentages are even higher when you're talking about fibromyalgia than sexual abuse. So just seeing how physical trauma affects the body, and it manifests itself in so many ways. I think would be part of that conversation.

Dr. Berry:                                And your line of work and of all the people you've seen, is there any common traits as far as who gets affected from sexual trauma, sexual abuse? Is there either gender or race or … Is there a pattern that you tend to see a little bit more often than not that, again, would or should clue someone like me to say, “You know what? This person's kind of checking a few boxes. I really need to make sure I'm addressing and trying to go after to make sure I know all what's going on.”

  1. Mesadieu: Every 98 seconds, an American is sexually assaulted. And every eight minutes, that victim is a child. That statistic alone tells us that children are very vulnerable to sexual assault. And I know what's been talked about in the media has been about women. They are vulnerable as well but I think we tend to miss a little bit of the conversation towards making sure that our vulnerable youth are knowing about sexuality and being protected in that manner.
  2. Mesadieu: One out of six American women has been the victim of an attempt or completed rape and about 3% of American men, so that means one in 33 have experienced being attempted or completed rape in their lifetime. Ages 12 to 34 are the highest risk years for rape and sexual assault. We're looking at the younger years here of where sexual assault happens. I mean, we know that it's a majority of women, but it does happen in males. One out of 10 rape victims are male. And the interesting thing is that males who are in college, who are attending college, ages 18 to 24, are approximately five times more likely than males who aren't in college to be a victim of rape or sexual assault. I thought that was pretty interesting, because in regards to campuses, while it's very much needed, the conversation about violence against women, we need to also be talking about violence against men and their increased opportunity here with being raped while they are in college.
  3. Mesadieu: The highest race with greatest risk of sexual violence is Native Americans, so that are the Indian Americans here.

Dr. Berry:                                Oh, wow.

  1. Mesadieu: And that is the cultural factors that are in place with that. Then when we're talking about the African-American community, while they are not in the spectrum of the high numbers or percentage, they're very much involved. But when we're addressing sexual abuse in the African-American community with women, we have to acknowledge that American history shaped the expression of black women's trauma. And we have to talk about how slavery plays a part into the pattern of the way that women were gazed upon, analyzed, owned, abused, and ridiculed for their African-American body.
  2. Mesadieu: When we're talking about slavery and … There's a pattern of watching them being attacked or abused by the slave owner and treated as the way that they want to, and then go into their own community and that happens as well, there can be a loyalty of protecting the individual who's doing the perpetrating in the community and so because of the silence and the shame, that continues. This is not only specific to African-American community, but the uniqueness is the American history of the way that black women were treated during slavery.

Dr. Berry:                                First of all, a lot of … Again, Lunch and Learn community, a lot of gems being dropped today, especially for the men. The men. And I've said this before, I think some of our men are like, as superheroes, they act like nothing happens to them. They act like they can't get sick. They act like they're invincible. And they tend to avoid the physician. I think in a misogynistic way, we talk about sexual trauma, sexual abuse. Again, I'm not going to speak for all men, but I think a lot of them really assume that this is a female, a women's problem instead of a problem that affects a lot of people.

  1. Mesadieu: Mm-hmm (affirmative). Yes, absolutely. I agree.

Dr. Berry:                                But those numbers, I'm actually surprised. I didn't realize it was that high.

  1. Mesadieu: Yes. And you know what? In childhood sexual abuse, it's even higher.

Dr. Berry:                                Wow.

  1. Mesadieu: It's even higher. In childhood sexual abuse, one in four girls get sexually abused and one in six boys get sexually abused. Those are things we're not talking about.

Dr. Berry:                                Wow. Wow, okay. All right, like I said, you know, I'm usually not stuttering or at a loss for words, but again, those are … This is a very telling topic. When you hear facts and figures and you're just like, “Wow.” It just takes you aback, because again, I think a lot of times, we think of this topic and we think, oh no, this is primarily women. Only primarily women are going to deal with this. And no, no, no. Clearly as day, there's probably a lot of men walking around now who's experienced some form of sexual abuse, trauma. And again, I hate that I'm just trying to gel the words, but I shouldn't. But they're experiencing some type of sexual assault that's occurred some time in their lifetime.

Dr. Berry:                                Again, one out of six. That's a lot of people. And they're still manifesting that even as adults. Do you see that a lot where something occurred when they were 12, 13, 14, 15 and they suppress it, they buried it, but now they have certain mannerisms and traits in their adulthood that you can almost, especially in your field with your expertise, point back to? Like, no, see what happened to you when you were 12? That's why you're acting the way you are now.

  1. Mesadieu: I think I know what you're getting at, and like I said, we never look at someone and assume because of the way that they're presenting themselves in front of us that we know exactly what they've gone through. We want to be careful with people's stories, and we want to be careful with the space and the pain and the hurt that's associated with that. But I will say, as people gain insight towards what they've gone through, you will definitely be able to see how it manifests itself later on.
  2. Mesadieu: I mean, there are people who they would never have even said out loud that they were sexually abused. And then they come into therapy because they have anxiety or they come into therapy because they're having relationship issues, and then I have time and time again where my clients, they'll come in and they're doing their initial assessment, and there's questions regarding specifically about sexual abuse, because I specialize in that and we know the high rates, and they go, “Well, I didn't even realize that that was sexual abuse,” or, “I haven't verbalized that was sexual abuse until I had to complete it in a questionnaire.”
  3. Mesadieu: Especially when things happen when you're young, we can repress them. And part of trauma, you lose memory. The repressions can be subconscious or it can be intentional, but yes, you definitely bury it, bury, bury. But it manifests itself in so many other ways, and at times, you don't know that that's related to your sexual abuse until you sit at the point and allow that to come into fruition through conversation.

Dr. Berry:                                Wow.

  1. Mesadieu: However that may be; through therapy or talking to someone else about their story, or you work in the field, or you see something on the TV that triggers you. However that may come. It starts to show it, though.

Dr. Berry:                                Please correct me with this analogy, because a lot of the patients, especially my male patients, when they come to the doctor's office, it's usually some back end way of why they're coming. Let's say they're having some issues, some sexual health issues and they want those big three medications. If they're saying, “You know what? I'm having all these problems here,” they may not directly come out and say, “Hey, I want the Viagra. I want the Cialis of the world.” But they have a whole bunch of different excuses of why they're coming, and then right when I'm about to get out the door, they say, “Oh, by the way.” Do you find that happening a lot as well, too, as far as they come in the door for something but then at the end, it's like, “No, no, no. This is what I really want.”

  1. Mesadieu: Yes. I'm laughing because it happens all the time, all the time. You'll talk about all these other things, and then it's like, “Okay, well, you ready to schedule for the next session?” And he goes, “Okay, before we go, I have to drop this whole entire bomb,” that unfortunately, you're not always able to compact with them. But yes, it does happen. I think people … We hear stories all the time, but each time, every time someone has to muster up the courage to make themselves vulnerable to share that. So I think that I never take it for granted when someone shares that with me, because I know all of the shame that comes with it and all of the vulnerability that's required. You sat here the whole time talking to me about other things, when in your mind, you wanted to share this with me. So yes, it happens. It definitely happens. And not just about sexual abuse; it happens about whatever in that moment is the toughest thing for that person to have gone through. They'll wait.
  2. Mesadieu: And I don't know if it's maybe if I say it really quick, then I won't have to fully address it in that moment, and I could just leave that with you. And if that's what you need in that moment, I'll take it on for you in that moment until we're able to impact it in a space that's comforting and safe and non-judgmental.

Dr. Berry:                                That is just too funny. Because yeah, right when you say that, it's like, I wonder if they do that to you guys, too. Because I know they do it to us. But I know that they usually never come out and directly say, “Hey, no, this is why I'm here.” All right, so again, I love to be enlightened, ladies and gentlemen. Again, this has definitely been an amazing one.

Dr. Berry:                                How, especially in your line of work, how has all of the events that's been happening, starting from Hollywood and trickling to almost every industry now, where you got people getting kicked off the Today Show. How has that affected your field? Are you seeing more of an influx, or is it a different … Is there more people coming, or are they coming at it different ways? What would you say that you've noticed as a big difference of the fact that now we are actually talking about it because we're forcing it in the open?

  1. Mesadieu: Yeah, absolutely. What I've noticed is exactly what you said; it's more of the discussion about it. What I am noticing is that when one person shares a story, the other person shares the story. What also happens is that I'll have clients who will tell me, “I was watching TV and this story came up,” and it triggered them. So I'm not saying that there has been a huge people running into therapy to talk about their sexual assault because of the things that are happening in the media. I'm not saying that that's not happening, but that's just not my personal experience in my practice.
  2. Mesadieu: But what I am experiencing is that there's more of a conversation being had with the people in their lives, and I'm seeing more conversations occurring in media, more conversations occurring on social media, and I'm also getting mail reaching out to me because they know that's what I do. And they're asking me, “As a man, what do I do with this information that I'm seeing? How do I look and see what that line is?” I had someone call me and ask me, “When does consent start, and how much responsibility is put on the male? Is this worth someone losing their job?”
  3. Mesadieu: It's just conversations that they wouldn't ask me that if they would've saw … if this wasn't happening in the media. So now I'm seeing that even guys are starting to reflect. This is serious. People are losing their jobs. Women are being hurt, and they're coming out in droves. We can't ignore it anymore, so how do I address that and how do I need to pretty much check myself as a male to see am I contributing to any of this occurring?

Dr. Berry:                                I'm so glad-

  1. Mesadieu: So that's-

Dr. Berry:                                Ooh, I love it. Ooh, I'm so glad you said the men need to check themselves. Because I'm privy to a lot of obviously male conversations, right? Because they feel much more freer to talk. And instead of saying, “You know what? I need to make sure that what I'm doing doesn't cross any line,” and I think we can talk about what consent means. They're talking in the sense of, “Oh, I need to protect my job.” Or, “I don't want women around me, because for some reason, I'm such an animal, I cannot control myself if there's a woman in the board room, and I cannot control myself if there's a woman in the office, so let me just get rid of them instead of trying to change myself.”

Dr. Berry:                                And again, and I'm speaking … I speak as a contingent, being privy to conversations. I'm like, does that make any sense? Again, I have two daughters. I have a wife. I have a mom. I have cousins. I'd never want them to ever feel that, one, they can't go to work. One, they can't act as if they want to act for fear of, oh, I might get fired. Or they're not going to be able to act, quote unquote “normal” around me.

  1. Mesadieu: Yeah, and I think that could bring a conversation about culture, too. We got to bring the conversation about what society deems as normal in regards to sexuality, we have to bring a conversation of how do I relate to a woman if it's not just about a romantic interest or if it's not just about two consenting adults? How do I have-

Dr. Berry:                                Talk to them.

  1. Mesadieu: You know? Yeah. I mean, in that conversation, he was like, “Well, don't women put these clothes on so that they can get attention or that they can get a comment? Or why do you do your hair? Why do you get your hair done? Isn't that to get a comment or attention to a man?” And I'm like, that is an unhealthy view about women, because the perception is that woman is here for the entertainment and attention of a male. And that is very unhealthy, and I think that can gauge into even if it's not your intention, to harass someone. But if you had that thought process going about how this is how I relate to women, then that can happen.
  2. Mesadieu: So I think the conversation is bringing up, how do you view women outside of the people that you're in a relationship with or outside of wanting to be in a relationship with them? How do you view them when you're looking at their bodies, even if it's not something that you say, but in the way that you're viewing, you're perceiving, your culture, your environment, and that's going to come out unintentionally or intentionally in the way that you relate to them professionally and in the way that you relate to them personally.

Dr. Berry:                                I'm so glad you said some of that, because I definitely wanted to make sure … Because I have a lot of men who listen to the podcast as well, and again, when I hear that conversation, I'm like, “Bro, what are you talking about?” You know, honestly, I have to say that. “What do you mean?” And they always use that crutch; “Well, you know, I have sisters. I have a mom. I respect women, but …” It's always a but. How come I can't talk about this in a certain way? And I say, “Once you have to say a but, stop right there.” That's where you should-

  1. Mesadieu: Right.

Dr. Berry:                                That's where you should end it.

  1. Mesadieu: Absolutely, and I think the confusion with the consent with this particular conversation is, okay, well, if I say or act or do something to one girl and she's not offended, and then I do it to another girl and she is offended, how do I as a male relate or know when I'm being offensive? When does consent start, pretty much. And when is it deemed sexual harassment? Is it deemed sexual harassment when someone gets offended, even though I said the same thing? Or is it deemed sexual harassment when whatever I say, even if the person is offended or not.
  2. Mesadieu: These are great conversations to have, and I think we should have them more in co-ed spaces, so that men could provide their perspective and women could provide their perspective in being able to respect each other and increase the conversation about respecting one another outside of sexuality.

Dr. Berry:                                Amazing, amazing gems. And you know what? Again, the men who are listening, you know what? If you have a question, just ask. Right? A lot of times, they won't even ask. They're like, “How come I can't do …” Did she say you could? I immediately will point to them, “What if someone …” Let's say if they're heterosexual. “What if someone of the same sex did that to you? Would you have no problem with that?” And automatically, you get the, “Well, I don't want … No, no, no.”

Dr. Berry:                                Well, if you can understand what it means to have an unwanted sexual advancement, unwanted sexual comment in your presence, unwanted display of power, because I think men use it a lot from a power standpoint, whether position in a job, position at work, position in school. I think they use it as power more than anything, and when we start saying, “Well, you know what? You can't actually talk like this around women in your office, or women in your school.” Right? I think they take it as, “You're taking my power away and I don't want my power being taken away in this matter. What other way can I circle around it while still keeping my power?”

  1. Mesadieu: Yes. I'm so glad that you mentioned that, because it feels like that sometimes. It feels like you're asking me, “Well, what can I do to change, but I really don't want to change. I really want you to not be offended, but how can I avoid the sexual harassment so I don't lose my job?” And it's, “Are you really asking because you want to know, or are you really ready to look at the things that we've been naturally conditioned …” This is not necessarily all your fault. Naturally conditioned to how to relate to women or how to … We're talking about men and women, but women with men.
  2. Mesadieu: I was in a place with someone that I was dating, and this woman walked up and just started touching all over his body. They didn't ask him. That's sexual harassment. And so I think we have the conversation about men to women, but there's also a conversation about women to men. It's, this person is not just a sexual being. How do you relate to them, and what is the conversations we need to have? And asking is for sure the number one thing, and being open to change your way of thinking and your way of doing things.

Dr. Berry:                                I know we don't have you for long, so I want to … There's a few more questions. For those who do come forward, after that step, because obviously it's a big step. We don't want to belittle the step of actually acknowledging something happened or something is happening. What's next for them? I think this is where you take the ball and run. What is next for them? What do you educate and empower them with to help continue moving forward?

  1. Mesadieu: Right. The main thing when someone has gone forward, and the gone forward doesn't necessary mean I went to media and wrote a letter. It doesn't necessarily mean I went to law enforcement and filed a report, because that generally doesn't happen either. It could just mean I disclose to somebody. I shared it to someone who was other than myself. I took it from outside of my head and something that I put in the past and I shared it to someone. The main thing there is gaining support.
  2. Mesadieu: It takes so much courage and so much pushing past stigma and pushing past shame, because realistically, there's a lot of victim blaming. I think the main thing there is not asking, “Well, what did you do for that to happen?” Or, “Why didn't you scream?” or, “Why didn't you push …” I mean, I was even reading a statute and it said, “If the person is physically able to resist, then …” That was part of the limitations. And I think even that is victim blaming. You're telling me if I don't physically resist, although someone has power, although someone might be using force, then therefore that's a limitation to you considering this being a sexual violation towards me. I think the main thing would be in that moment is providing support, emotional support, physical support. Linking them to professional help, which would be me-

Dr. Berry:                                Yes.

  1. Mesadieu: … or group therapy, or we have our local victims advocate. There would be considered professional support. Knowing what's out there. Getting medical examination if it involves sexual activity which is appropriate, getting an HIV testing to make sure that you are clean and that you are safe after you've been violated in that way, and allowing, just even as physicians, allowing them to bring people in with them if that's the reason that they're coming, of whatever type of support that they need in that moment.
  2. Mesadieu: The next thing that they need is safety planning. Brainstorm in ways to feel and be safe again. Once you're violated sexually, verbally, you're playing that in your mind. You have flashbacks towards that. You may get triggered by things that you're not even aware that were triggering you. Sitting down and talking as a support, what do you need to feel safe in this moment? What do you need to feel safe next week? Who are the unsafe people that you feel uncomfortable around? And creating a system for where they constantly know that they are safe, because when you're violated, you lose your sense of security.
  3. Mesadieu: Calling the National Sexual Assault Hotline, which is at 800-656-HOPE, 4673, and having people readily available to talk to you through it. I think crisis hotlines and rape hotlines, sexual assault hotlines, national suicide hotlines, all of those are great because they're generally anonymous. So even if they felt like there was no one in your life that you could talk to, you at least know that you can call someone up who will be able to walk you through how you're feeling, even if it's just for that moment or for that five minute phone call that you're on. Then also, looking at reporting options, because we do want to make sure that if you know who it is, you are reporting it so that they're not then offending other people.

Dr. Berry:                                Do you ever place a timeframe where they should … I hate to say it, but they should, I guess, move on? Is there ever a good time when after a month, after six month, after … Is there a one size fits all when you talk about moving forward?

  1. Mesadieu: There's not a one size fits all, and when we're talking about therapy specifically, some people, they come in, and they're in therapy for a few months and they feel like, “I'm processing this a little better. I can move forward.” And then there's people who find it beneficial to stay in therapy and have it to be more long-term. There's never this is exactly how long you should take, and after that, you're lingering just on the side. There's never that, because it affects so many aspects of your life. It's not just, “That happened to me.” It's, “That happened to me, and that is associated with so many different things that I'm going through.”
  2. Mesadieu: In therapy, you're providing a place to talk through the problems and the challenges, and they're learning new coping skills and they're learning ways to deal with their feelings, and their strategies and their stress. You just never know what triggers, what sets you back. Or what new experiences that are coming up that are related. We're talking about intimacy issues in marriage that could be based on the fact that you had sexual trauma. We can talk about shame, anger, resentment, anxiety, self-worth. How long does it take to build back your self-worth? Would you say that's a few months, or would you say that's a few years? It's just really hard to say.
  3. Mesadieu: I personally would go on the end of, if it took them 40 years … Let's just say 40 years, because it happens. If it took them 40 years just to tell someone else that they were sexually abused, how long do you think it would take for them to be able to walk through that in all those years that they went without sharing?

Dr. Berry:                                Very powerful. Very, very powerful. Before we go, for one, we definitely want to let people know how they can find you. But for someone who may be listening and just judging off the numbers, it's a pretty good chance that someone's listening who hasn't come forward. Is there anything that you would say to them that's say, well, I know it hasn't happened yet, but eventually it happened. Is there anything that I can say or you could say or something that … help them, say, “You know, there is help out there.”

  1. Mesadieu: Yeah, absolutely. I'm glad that you mentioned is there anything that you could say, because what I would like to see in regards to physicians, specifically, is being able to open up that question in a natural way, to where it doesn't feel like it's something that you're trying to avoid, we all need to check our own comfort level with asking the hard questions and allowing the space for that to happen, and knowing that someone's story is their story, and you're not pushing them to share their story. But you're allowing them to know that at all times, there's someone there who could support you in that. At all times, even if it's no one in your life, there's someone there who can relate to what you go through and there's someone there that you do not have to walk through those pain, through those memories, and through the discomfort by yourself.
  2. Mesadieu: For someone who hasn't mentioned it to anyone, to someone who hasn't gone forward, I want them to know, number one, it's never your fault. It's never your fault that that has happened to you, that someone has violated your trust in that way. And two, I want them to know there's always hope and there's always someone, one person, that you can turn to for that comfort and for that level of safety. I think that's the key thing here when we're talking about dealing with sexual assault.

Dr. Berry:                                This has been absolutely amazing. Again, I can't understate how amazing it's been to have someone in your field, an expert like yourself, be able to really educate. Again, I know you're educating the Lunch and Learn community, but I can tell you, you definitely have educated me. The wheels are turning as far as what can I do as a physician to make sure I'm asking those questions and making sure it's not super awkward or something I'm just trying to get through to get to the next patient room. So thank you

  1. Mesadieu: Do you have it included in your screenings, any type of trauma?

Dr. Berry:                                I can tell you-

  1. Mesadieu: For a patient family history, or patient history?

Dr. Berry:                                I can tell you we do not. It's definitely not something that … And it's weird because usually, our medical history is, “I hypertension, diabetes.” And maybe one of the questions, if I think about it, maybe a couple of those questions may have it, but they probably have to go through 10, 15 different medical diagnosis before they even get to that point. Again, that's the physician, the health practitioner has to go to 10 to 15 different medical questions before they may ask. I'm not even saying they will. They may ask. If it's checked off, great. But the likelihood that a physician's going to offer up, “Hey, by the way, anything …” is extremely low. Unfortunately.

  1. Mesadieu: Right. Yeah. I would say that would be part of providing that safe space too, right? If I already see that you are putting it on a screen or that you're opening a discussion, even if I don't want to tell you that time, I can see that this is a safe place for me to talk about this, because you're acknowledging it before I have to. So if there's ever a place where I want to talk to my physician about it, I know that I can talk to him because that has been somewhere in some aspect of the screening or a conversation or something that some brochure, whichever, is there. I would say that that would be part of helping to bring in a safe space professionally in a physician's office.

Dr. Berry:                                Amazing. Before we go, please tell our community, how can they get in touch with you? Because I think there's people who are going to be listening to it, people are going to read this and read the transcript and want to seek some help. How can they get in touch with you?

  1. Mesadieu: Absolutely. They can always get in touch with me at SoulSpringFlorida.com. I am at Rhodena at SoulSpringFlorida.com. Our practice has a website, and we are also on Facebook, so you can like us at Soul Spring Counseling. And yeah, that is the best way to get in contact. I'm also on Twitter, at Rhodena_M. If you wanted to get in contact with me on Twitter, if you wanted to send me a tweet while you're listening to this, I could definitely respond. We can engage in a conversation, we could take the conversation to Twitter as well. Those would be the main channels to get in touch with me.

Dr. Berry:                                And everybody, we will have a full transcript, and obviously in the show notes, we're going to have all of your contact information as well, so even if you're driving and you can't write down everything, you'll have access to it. And please reach out. If this is a topic and you've seen the TV, you've read the blogs, you've read the news, and you've seen all of these things happen and in the back of your mind, you're saying, “You know what? I think I may be a statistic in this amazing topic here,” please feel free. Reach out to her at your earliest convenience, at your private time. Because again, getting help, empowering yourself is really why we do what we do on a daily routine. We love to see the transformation, love to see the mental strength that comes from saying, “I have a problem and I need help, and can you please help me?”

Dr. Berry:                                So please feel free again, bombard her. She has been absolutely amazing. Again, for Lunch and Learn community, thank you for all that you do. And again, as always, Dr. Berry here, helping to empower you to take control of your health today.

  1. Mesadieu: That's good. Thanks for having me.

Dr. Berry:                                Hey, Dr. Berry here. You have just listened to another great episode of the Lunch and Learn with Dr. Berry. Hope you learned something from today's episode. Hope you learn from all of the episodes that you get a chance to listen to. Before you leave, if you not have already done so, go ahead and subscribe to the podcast. I am everywhere where you like listening to podcasts at, whether it be Apple Podcast, Google Play, SoundCloud, Stitcher Radio, iHeartRadio, wherever you like listening to podcasts, the Lunch and Learn with Dr. Berry is there.

Dr. Berry:                                Also, go ahead and follow me on my social media outlets. I'm on Instagram. I'm on Facebook as well as Twitter. All at Lunch Learn pod, whether it be Twitter.com/LunchLearnPod, Facebook.com/LunchLearnPod, and Instagram.com/LunchLearnPod, where you can get any videos, any pictures I may post, any messages or writing. Please follow me on there, right after you go ahead and subscribe to the podcast, and right before you leave me a five star review on either Apple Podcast or Stitcher Radio, or wherever you can actually leave a review. I'm much appreciative of all you guys' support, and like I said earlier in the show, I will see you next week. Bye.

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