Season 3 Episode 2: Perpetrators' Weaponization of Mental Health and Addiction Against Survivors

Have you ever seen survivors’ mental health or substance use issues turned against them by a domestic violence perpetrator? Have you been concerned about a domestic violence survivor’s treatment being sabotaged by an abusive partner? In this podcast, David and Ruth explore these questions and talk about how a perpetrator pattern–based approach can help protect survivors against these behaviors.

The show is broken down into three major themes: 

• What is weaponization of mental health and addiction?
• Why are systems are vulnerable to these manipulations?
• How we can fix (or perpetrator-proof) our systems?

Ruth and David explore strategies for improving clinical practice including assessing how current coercive control is impacting access to treatment. They discuss how important it is to recontextualize survivors’ issues back  perpetrator’s patterns of behavior as well as examine the implications of documentation and reporting to family court and child protection.

Now available! Mapping the Perpetrator’s Pattern: A Practitioner’s Tool for Improving Assessment, Intervention, and Outcomes The web-based Perpetrator Pattern Mapping Tool is a virtual practice tool for improving assessment, intervention, and outcomes through a perpetrator pattern-based approach. The tool allows practitioners to apply the Model’s critical concepts and principles to their current case load in real

Check out David Mandel's new book Stop Blaming Mothers and Ignoring Fathers: How to Transform the Way We Keep Children Safe from Domestic Violence.

Visit the Safe & Together Institute website.

Start taking Safe & Together Institute courses.

Check out Safe & Together Institute upcoming events.

Transcript

Copy Transcript Copied

[00:00:16] And we're back and we're back.  [00:00:17][1.5]

Speaker 1: [00:00:18] Welcome back to partnered with the survivor  [00:00:20][1.7]

Speaker 2: [00:00:21] and I am David Mandel, executive director of the Safe and Together Institute.  [00:00:24][3.1]

Speaker 1: [00:00:25] And I'm Ruth Stearns Mandel and I'm the e-learning, communications and strategic relationship manager.  [00:00:31][5.6]

Speaker 2: [00:00:32] And this is a podcast about everything domestic violence, and we sit and talk with each other. We do interviews. We dove deep into topics related to domestic violence informed practice.  [00:00:43][11.0]

Speaker 1: [00:00:43] Yes, and children and children.  [00:00:45][1.4]

Speaker 2: [00:00:46] And today is one of our classic sitting around in the office chatting about weaponization of mental health and addiction issues against domestic violence survivors by perpetrators.  [00:01:03][17.4]

Speaker 1: [00:01:04] Yes, this is a really big topic, huge topic.  [00:01:07][2.5]

Speaker 2: [00:01:07] Whenever we post on Twitter, we get a huge amount of attention. Yeah, it it's really important. I just did a keynote at our our conference, which we had 250 people at. That was awesome. That was last week.  [00:01:21][13.2]

Speaker 1: [00:01:21] Oh yeah. But it was also a North American and European conference, right? So there was a there was a nice mixing of lots of different practitioners from different areas of practice, but all who are committed and dedicated to making systems change and creating domestic violence in foreign practice. So anywhere from mental health practitioners, doctors there was a doctor there to a medical practitioner that is to domestic violence, child protection judges, family court. So it was an amazing mixing of minds and it's a great place for ideas and new practice to come about and an energy for change. So we had a great time  [00:02:10][49.5]

Speaker 2: [00:02:11] and I gave a keynote on how trauma informed is not domestic violence informed. So today's podcast is going to be in the same vein. I just find that people are really interested and and particularly survivors. I mean, I think that may be the best way to start that, that survivors respond really well to this topic. I think because they feel seen and validated, right?  [00:02:37][25.4]

Speaker 1: [00:02:37] Because this is our actual experience in the world. That's right. Whether or not you acknowledge that or want to change that, it is our experience of the world.  [00:02:46][9.4]

Speaker 2: [00:02:47] Yeah. And I think it's an experience that is not still in the mainstream of the discussion of domestic violence in the sense of it really involves these siloed systems, right? You know, the addiction practitioner, the mental health practitioner and the domestic violence systems are still really siloed as much as people have been working to break those silos down. I'm going to  [00:03:10][22.7]

Speaker 1: [00:03:10] challenge the just the silos. I have to be honest with you. I think it's just the silos when you have this sort of top-down sense of professionalism, which also inundated the medical field and also the mental health field, which says that you are the subject of my observation and I am the authority of your experience. And I get to dictate treatment plans. I get to take away your your personal liberties. I get to label you with pathologies. Then we are in dangerous territory already the power dynamic of a structure that has the authority to define humans in that way when really they're trying to define it based off of research, which is emerging and research and science have been used in ways that are abusive. If you look at the justifications for social policies, including the removal of indigenous children, those were fiercely defended at the time by social scientists and social theorists, and they used research quote-unquote to defend that. So we really have to dig down into the power dynamics of our systems, as well as seeing how they're siloed because there's many professionals who believe that their training gives them the authority to dictate other people's experiences to the world and put value judgments on those and then tell us what to do and then remove our liberties when we push back and say, that's not my experience of the world. That is not what is happening here, and I do not accept your treatment plans or your interventions because they will make me more in danger.  [00:05:09][118.6]

Speaker 2: [00:05:10] You go right to the heart of things all the time and you sorry. Apologize. You know, you're really speaking this idea of of the the prioritization of professional frameworks and perspectives and theories over the lived experience of survivors.  [00:05:26][16.5]

Speaker 1: [00:05:27] Response. That's right. To the realities of the organism that we are observing, right? It is actually a deeper form of scientific observation. And what we have been doing is social theory, which is really grounded in a lot of people's opinions and biases and value judgments which are formed, the religion and other deeply held beliefs. That's not the way we can move forward. We have to observe what is happening to people. What are the results of our interventions? As the family strengthened, as the family weakened, our children, traumatized our adult survivors traumatized. And that's just observational.  [00:06:07][39.9]

Speaker 2: [00:06:08] OK, so here we are and running through that. You know, you just started that. And so what we're going to do is, I do love you for that. I do love you for that. And. And so we're going to talk about what do we mean by weaponization? We're going to talk about why the system is vulnerable to weaponization or systems are vulnerable. And then we're going to talk about solutions, why we always try to get solutions and things that are always that are practical and and and  [00:06:34][25.9]

Speaker 1: [00:06:35] we want people to be thinking of solutions that's right along the way if they know practices or or or mandates or in, you know, intake, you know, mandates that are directly in contradiction to good practice, they should be thinking as we talk about how to marry safe and together principles and transform those things so we can transform practice.  [00:06:57][22.9]

Speaker 2: [00:06:58] That's right. And we want people to come and we want people to to like episodes that they like and share them, but also give us feedback and write us and you know, and reach out to us. So, you know, the definition of weaponization of mental health and addiction is is is really simple. In some ways, it's when domestic violence perpetrators. Use. Problems. Depression, anxiety, addiction issues, drinking against a survivor, particularly in family court, particularly in child protection, but not only. And turn those things against them as an attack, right? As an attack on their character, as attacking their ability to parent or attacking them as a person. Now you and I were talking beforehand about this, and a couple of things stand out for me. One is, and I want to keep coming back to this. Some of these issues that are raised by perpetrators are completely and totally fabricated. Right? I mean, I think this is to me that doesn't mean  [00:08:04][66.2]

Speaker 1: [00:08:04] they don't believe them.  [00:08:05][0.8]

Speaker 2: [00:08:06] Why would they may? They may believe them, but it doesn't mean that they may be true, right?  [00:08:10][4.5]

Speaker 1: [00:08:10] True. Right.  [00:08:11][0.5]

Speaker 2: [00:08:12] In their minds. But but they're not. They're fabricated. What I mean by that is, is this is starting off for me as a as a professional. I think a lot of times this thing goes to your point, which is people want to say, Well, aren't we really talking about when we talk about mental health and addiction and domestic violence? Are we talking about the impact of trauma? Well, and they want to put the connections between domestic violence and and these other things in a very narrow box and a clinical box and a oh, what happened in the past box?  [00:08:42][30.3]

Speaker 1: [00:08:43] Now it's ongoing.  [00:08:43][0.5]

Speaker 2: [00:08:44] Now that it's ongoing, nothing is happening now.  [00:08:46][2.1]

Speaker 1: [00:08:46] It's the fear of the violence in the future.  [00:08:48][1.6]

Speaker 2: [00:08:48] That's right. And past  [00:08:50][1.2]

Speaker 1: [00:08:50] and present  [00:08:50][0.1]

Speaker 2: [00:08:51] reality that's impacting people now, which will get to live more in depth. But but they also struggle with the idea that under this bucket or under the Sabella is are things that were domestic violence perpetrators just saying everybody, she's crazy. She's bipolar. She's depressed and she can't watch the kids and and they start giving survivors diagnoses and throwing around terms. And then all of a sudden you see these things because they're repeated, because they're written down and case notes. Yeah. Then all of a sudden they take on a life of their own. And the survivor, a minimum, has to spend time defending themselves from these false allegations.  [00:09:32][41.5]

Speaker 1: [00:09:33] Right. And can and often does appear all of those things to people who don't understand the context of the danger. Or the ongoing harm, coercion, emotional verbal abuse, because essentially, if we were to look at ourselves as responding to stimuli, survivors are responding to this ongoing pattern of behavior, which causes them to be in a very specific fight or flight state when we see somebody running away from somebody who's chasing them. We understand those responses. OK, if we see somebody, but we don't see the danger, but we see them behaving in ways in which a person in danger would behave in. We consider them to be severed from reality. But the problem isn't with them. The problem is with us.  [00:10:31][58.7]

Speaker 2: [00:10:32] That's right. And I think that goes back to early and long term fears from the women's movement that the mental health movement isn't their friend in these areas and that really that there is this idea that once you start decontextualized and I use this word a lot now that part of the problem is we start contextualizing women's addiction and mental health issues from the pattern, of course, control that's there that caused it or made it worse or is part of how the perpetrator interferes with somebody getting care.  [00:11:07][34.8]

Speaker 1: [00:11:08] I understand what you're saying and I completely agree with you. And at the same time, I don't believe that the structures of the mental health community were made to advocate for people who are victims of abuse. That fundamentally the people who formed those theories like Freud and John, who were white supremacists, who were racists, who called women hysterical, worked those biases into their frameworks. And we have not had the fortitude or the adult mentality to stop and undo those biases and look at them and see how they're built in there and see how they're impacting people there. There hasn't been a systemic review of how the mental health framework is not functioning well to hold accountable people who are causing pathologies or exacerbating them, and they've never been concerned with that. They're not concerned with accountability. So how exactly do you take a framework that's fully focused on a survivor already by its very nature? And how do you make it accountable?  [00:12:23][75.6]

Speaker 2: [00:12:24] Right? It is very hard to turn systems that are focused on symptoms, diagnosis and treatment of individuals and turn their attention towards the behaviors of the perpetrator and conversations about the perpetrator. And and how things work that way. So let me give an example. You know, I started by talking about, you know, I got caught up in talking about fabricated. Allegations, but I want to talk about this broader range of sort of the weaponization of mental health and addiction issues. And I've been thinking a lot about this and listening to survivors and thinking about examples of cases I'm working on. And and for me, a lot of times I like slowing down what's going on. I like slowing down the jargon and I like breaking it apart, like thinking about it a little bit a little more deeply. And so I started thinking about the statement that perpetrators make, which is you're crazy right to a survivor, fairly standard treatment, fairly standard issue, standard issue in abuse. So and and really thinking about that kind of statement or, you know, and it gets often thrown into this bucket of his emotionally abusive or he calls her names. You know, and I start thinking about, OK, what's the impact of that or what's the intent and what's the focus of that if it's directed at the survivor? Right. Right. Control. Control and control, you know? But but in terms of the impact it may have on her self-esteem, her sense, a sense of herself, whatever is associated with undercutting her perceptions. You know, if you're saying you're crazy for thinking that I'm cheating on you, right? You know all those things.  [00:14:05][100.7]

Speaker 1: [00:14:05] Are you crazy for thinking that that may be kicking in the door traumatizes the children?  [00:14:08][3.6]

Speaker 2: [00:14:09] That's right. So all these things that are that are really like that, but then take that same statement and and have it said either in front of the kids or to the kids. Your mom is crazy. Don't listen to her. Now I'm starting to undercut that mother child relationship, so it serves another layer of purpose.  [00:14:26][17.0]

Speaker 1: [00:14:27] But it's still control.  [00:14:27][0.5]

Speaker 2: [00:14:28] It's still control  [00:14:28][0.3]

Speaker 1: [00:14:29] of a different person. That's right. To control the survivors.  [00:14:31][2.1]

Speaker 2: [00:14:31] That's right. You know, so it's attacking that parent child relationship. But now think about that being directed to his parents, her parents, friends, employers, employers. OK. So again, mandatory reporting. Unless I get to the core, you know, I want to separate that.  [00:14:47][15.4]

Speaker 1: [00:14:47] I know that you will like that whole tree. You know that this whole?  [00:14:50][3.3]

Speaker 2: [00:14:50] No, but I think you can, because each one you could map all these things. I think each one of them, each one of them has a different impact. It's the same statement. It's the same content, right? And we, I think professionals often lump these things together.  [00:15:05][14.7]

Speaker 1: [00:15:06] Well, let's just put it this way. Yeah. When survivors, you know, bring forward allegations a lot of times, especially if that happened in childhood, we're doing that in adulthood. We fear being charged with slander. Right? Right. Or other things. How is it that perpetrators can call us crazy with child protection and police and mental health people and not be accountable for that? But when we tell people about the abuse that they've perpetrated against us, that's slander. Have you ever wondered that  [00:15:42][36.7]

Speaker 2: [00:15:43] I have not wanted that, but maybe I should.  [00:15:44][1.6]

Speaker 1: [00:15:45] That question is hanging out in the universe.  [00:15:46][1.5]

Speaker 2: [00:15:47] Maybe, maybe some of our lawyer friends will comment on it. You know what point? One point can that become slander and illegal?  [00:15:52][5.2]

Speaker 1: [00:15:52] How many times have you seen that perpetrators have multiple false allegations and child protection? Multiple false calls to the police? Multiple, whatever? How many times have you seen that?  [00:16:06][13.4]

Speaker 2: [00:16:06] Well, you can be charged criminally, as far as I know with with making false reports, knowingly false reports to the police.  [00:16:12][5.4]

Speaker 1: [00:16:12] That's my child protection,  [00:16:13][0.8]

Speaker 2: [00:16:14] and I don't know about that. Actually, that's kind of because  [00:16:16][1.8]

Speaker 1: [00:16:16] most of the time it's anonymous.  [00:16:17][0.8]

Speaker 2: [00:16:17] Yeah. Well, it's interesting. It's a really good question. You know, so let's kind of think about those things made reports made to the family members. Right? You know, which is about, you know, just again, attacking that relationship. And in some sense, you know, likely trying to cut that person off from support. Right? Absolutely. You know, in addition to protecting myself from the consequences of perpetration, I'm also trying to, you know, cut people off and we heard, you know, from a lot of ODB survivors. You know, it was a common refrain as we were spending time on officer involved in this. That's right. Officer involved domestic violence that that that they watched their um, their police officer partner tell other police officers our friends with. She's crazy. She's overreacting. She's depressed. This is all these things. So in case she called the police or start talking to his friends, they wouldn't believe her. I mean, these are very, you  [00:17:15][57.6]

Speaker 1: [00:17:15] know, tons of verbal like right permutations of this crazy overreacting, right? Sensitive. Right. You know, there's there's these are all terms right  [00:17:27][11.5]

Speaker 2: [00:17:27] attached, right? But and you get some perpetrators who will literally use diagnosis. She's bipolar. Right? She's manic depressive. She's she's got postpartum depression.  [00:17:38][10.6]

Speaker 1: [00:17:39] Uh-Huh. The new one is,  [00:17:41][1.4]

Speaker 2: [00:17:41] yeah, this is narcissism.  [00:17:42][0.5]

Speaker 1: [00:17:42] All the fad.  [00:17:42][0.3]

Speaker 2: [00:17:43] That's narcissistic. She's narcissistic. And then the last grouping that I can think about is is that when this gets directed to professionals, whether it's. Child protection, you know, mandatory reporters and court personnel, it actually takes on a whole other level. That's why impact and and  [00:18:02][18.8]

Speaker 1: [00:18:03] yet again, there are no consequences for those false allegations in that context. Nothing is being done right.  [00:18:13][10.0]

Speaker 2: [00:18:13] And again, I want I want I want to to include in this places where it's false allegations. But we're also real issues like anxiety, which, you know, depression, PTSD, PTSD start getting weaponized by being by being tied to this idea that somehow she can't parent.  [00:18:34][20.2]

Speaker 1: [00:18:34] So here's I think we need. We need to press the pause button. OK? So I'm not quite sure how parental evaluations or assessments work in child protection or in other contexts like family courts, but a mental health diagnosis is not evidence that a person cannot parent. Right? Absolutely. Nobody has assessed that person for their parenting in light of that mental health diagnoses. If you have not looked at that person's pattern of behaviors in regard to parenting, you do not have the expertize or authority to simply use a mental health diagnosis to make that determination. That's right. That is reckless and that is not OK.  [00:19:20][45.3]

Speaker 2: [00:19:20] Well, and this is this is so fundamental. I mean, you know, I wish I could like visually underline that or put an exclamation point and y'all could be watching and saying that because that is one of the big takeaways for me. You know, which is anybody out there who is really looking at these issues, really to be thinking about and watching for where people start automatically assuming that somebody has depression or anxiety is automatically relevant to their parenting or is automatically a negative mark against their parent.  [00:19:54][33.4]

Speaker 1: [00:19:54] This also happens to women who have disabilities. It's it's the weaponization of the perception and the flaws within our court system and our family court system, in our custody and access system and our mental health system. That's saying it's so, it's so pernicious. Go get help. If you feel depressed or you have PTSD because somebody abused you, go get help, that's your responsibility. And then we go, do it. We get labeled with a disability or with a mental health condition so we can get help. And then that is used to discredit us. That is just absolutely insane. All of society, all of the medical community, all of the mental health community, all of the official agencies everywhere are telling us to use these systems to help us. And then when we're diagnosed with a disability because you said you would help us and give us access to resources, you tell us we cannot parent our children because you won't give us the actual help that we need. That's what's happening.  [00:21:08][74.0]

Speaker 2: [00:21:11] And to add to that, we look at the perpetrator. And say, well, the couple separated and maybe there was an issue of domestic violence perpetration. Maybe there wasn't. But now that the couple's split ends, domestic violence history, if we ever believe it happened at all is not relevant to parenting decisions. Yes, because it's what he directed at her.  [00:21:35][24.4]

Speaker 1: [00:21:36] And this is one of the reasons why recently a little boy in Italy died. His throat cut by his father because the judge decided that his history of violence towards other adults had no bearing on his child.  [00:21:54][18.2]

Speaker 2: [00:21:55] That's right. And what we see here and this is, you know, why this is this is part of getting into why the system is vulnerable, right? Is gender bias right? You know, women's. The weaponization of of. Domestic violence survivor mother's mental health, her addiction is real or fabricated, falls in the fertile ground of of cultural stereotypes of one. Women are more crazy, more emotional and to higher stands for mothers as parents.  [00:22:23][28.1]

Speaker 1: [00:22:23] If my mental health diagnosis is an automatic mark against my parenting, why isn't the fact that the perpetrator has a history of gang violence attempted strangulation? Any of those violent, Margaret, why is that not pertinent to child rearing? Why? It's because. I'm not a man I hate to say it is because I'm not a man and because men are not expected to be nurturing. Women are expected to be nurturing and therefore it said she has a mental health condition. She can't be nurturing enough to her child. But her partner, who has a history of of gang violence of adult to adult violence of domestic violence and sexual violence, is perfectly capable of rearing this child in a responsible and healthy way.  [00:23:19][56.1]

Speaker 2: [00:23:21] If you if you look, I've been I've been looking at Google for some writing I'm doing and around the definitions of mothering and fathering. And the definition of mothering has where words protective, caring, nurturing right. The definition of fathering is the biological definition. You mean sperm? Sperm donation, you know. But but I think it really, you know and and also you find that the term mothering is googled at the rate of five times more than that than fathering or fatherhood. Right? And just so you know what you're saying, I think is back to that low standards. And so I actually think I've come to believe that as it comes to particularly family court and courts and access issues, that women's involvement with with the mental health and addiction services system is often a detriment to their position in the Family Court, what they want to get and that actually that that the fathers who are domestic violence perpetrators, their involvement with those systems actually works in their favor. And I'll tell you why. I think that one is because those systems are not calibrated to really assess coercive control and the impact of those on on families and and and on children, particularly  [00:24:33][72.8]

Speaker 1: [00:24:34] a perpetrator made to divide property, including children.  [00:24:38][3.5]

Speaker 2: [00:24:38] We talk about Family Court. I'm talking about the number, the mental health, oh, you're talking about the health that you were going into? No, I mean, I'm talking about the Family Court setting. And so if I go and then see a psychologist. One is, I think, men access services less. There's less documentation  [00:24:53][14.4]

Speaker 1: [00:24:54] about men, right? Men don't go mental health help that we begged them to, right. We bet their partners beg them. That's right.  [00:25:00][6.3]

Speaker 2: [00:25:01] They don't do it. That's right. So there's going to be less documentation seems to be less involvement. So so that's going to work in their favor and against survivors who go and get help. Right? Two is that once you get involved with those systems, addiction, mental health systems are going to focus on diagnoses of depression, right? Or other things. And they're going to defocus the violence and the control. Yes, because that's not their framework. And so what's going to happen is any input coming from those professions may feed into the court. Maybe he's got addiction. Maybe he's they'll say, Oh, he's got addiction. But he stopped drinking. He's depressed, but he's taking medication and his violence will fade into the background even if he ever was an issue. And and there we go. He's one up and she's one down the family court system. And again, this is why and by  [00:25:47][46.9]

Speaker 1: [00:25:48] the way, for doing exactly what we were told to do, right? And this is where, you know, you know, we really need an honest reckoning of all of our systems. And you know, we are told that calling the police report and doing all of these things is our duty as survivors. And oftentimes the pressure is put on us to be the responsible party to make sure that there's accountability. But there is very little claiming and analysis and pulling up of the big, big person pants to admit the failings of the the ecosystem and interventions and all of the different systems that we're touching on. They have a huge responsibility to.  [00:26:34][46.0]

Speaker 2: [00:26:35] You know, it's so layered because, you know, I've talked to mental health professionals and to survivors who have told me this too, saying, Well, I've been ordered and this is kind of a catch 22. I've been ordered to get mental health counseling as part of a family court matter as part of a child protection matter. But my adult mental health clinician will not comment on my parenting because they feel like that's outside their purview. Right? And so they're in this catch-22 where they're going to do exactly what you said, which is they're going to get the help they were either ordered to or wanted to or expected to. And then they're being told by the clinician. And you know that I'm not going to comment on your parenting because that's outside Moscow, because the the clinician is worried about the liability. Yeah. And practicing out of scope from their point of view.  [00:27:20][44.9]

Speaker 1: [00:27:20] Interestingly enough, nobody is telling them that they're practicing outside of their scope of practice by making mental health diagnoses without understanding the violence behind it,  [00:27:32][11.9]

Speaker 2: [00:27:33] and that they're without  [00:27:34][1.0]

Speaker 1: [00:27:34] education, without informing themselves with whatever one or two hour class they get about general domestic violence, which is poorly framed, already framed towards the victim and is victim blaming already for most of these trainings. I hate. To say it, but you know, they're already practicing outside their scope of expertize. They don't have any expertize about domestic violence involved families. They don't know how to do that, and they need to start admitting that they don't.  [00:28:06][31.9]

Speaker 2: [00:28:07] Well, I think this is where, you know, we start thinking about and we'll talk more towards the end of the show about raising standards of expectations around practice, you know, for instance, screening for coercive control as a routine aspect of any mental health assessment. You know that being really part of it, but we'll come back to that. But I also want to talk about the vulnerability, why systems are vulnerable to manipulation in this way because of their focus on pathologies and deficits and not on strengths and forms of resistance. And I think this is, you know, I think we we talk particularly, I think in social work, you know, we'll talk about strength based practices. I think in mental health, we'll talk about empowerment. We'll talk about healing. Yeah, but  [00:28:50][42.4]

Speaker 1: [00:28:50] I want to know what that means.  [00:28:50][0.6]

Speaker 2: [00:28:51] Right. But but I don't think we talk a lot about because this is not about in some ways, it's not about psychology. It's about behaviors, right? It's about understanding the behaviors of survivors, the strategies that use the heroic strategies, the amazing strategies they use to protect their kids, to protect themselves, to placate the perpetrator, to kind of keep the household running, to keep their job.  [00:29:13][22.2]

Speaker 1: [00:29:14] I was like, You know, how many people have actually thrown their bodies between somebody who was being violent and their children?  [00:29:20][6.0]

Speaker 2: [00:29:20] That's right. And how does that get talked about, you know, and how does it get folded into the mental health? It's seen as heroic? That's right. And how does it get folded into the mental health or addiction framework? And more importantly, how does it get validated back to that survivor, but then documented and shared back to child protection, shared back to family court? You know, and so that failure of of being strength based and being focused on protective capacities again harm survivors that unbalanced view. Symptoms, diagnosis, treatment, right, right?  [00:29:58][37.4]

Speaker 1: [00:29:58] Well, it's a very reductionistic way that we've formatted our medical, you know, and interventions and it has to change and it has slowly been changing in other areas. But we don't have that holistic view and we don't have the resources again, the tools in a lot of our communities to understand how to build those holistic networks of support for survivors.  [00:30:25][26.4]

Speaker 2: [00:30:26] Well, I think a team and thinking holistically about functioning, not just, you know, diagnoses and symptoms, I we think about you, you look at the predominant Western framework for medicine. As you know, this is this list of symptoms, right? You know, and you meet this criteria and you have three of these five symptoms. And you know, how is this different from another kind of diagnosis? And you know, it's very tied in in the United States of these to insurance and reimbursement? Yeah.  [00:30:54][27.9]

Speaker 1: [00:30:55] And it's also tied into the largeness of our institutions. You have to have repeatability and replicability. You know, you have to have key performance indicators and standards and assessments. And all of that has been framed in a very incident's focused way with the biases that we spoke about previously. I mean, when you look for example, at the artificial intelligence that's being used by some child protection agencies now, which is supposed to be predictive analytics for child removal to increase safety and reduce human error, it is a horror show because their measures are very, very, very fundamentally biased and actually don't have to do with perpetrators patterns. They have to do with key performance measures or key measures, key risk factors that we've identified, such as pregnancy or poverty. And that shifts the focus by very virtue of the the the the nature of the tick box from the person who's choosing violence and their patterns to the survivors and children to mandate to them.  [00:32:17][82.0]

Speaker 2: [00:32:18] You're right, and many have even seen that with, you know, high risk teams and other kinds of of kind of multi-agency settings where there's a lot of emphasis on risk assessment, you know, is that literally there will be a box for disconnected from the perpetrators pattern about certain characteristics of the survivor like pregnancy, like depression, like addiction with no explanation around, you know, how the how that makes them more vulnerable to the perpetrator.  [00:32:45][27.1]

Speaker 1: [00:32:46] But you have to understand that racial demographics are also worked into these key risk factor indicators. And so it compounds the racial disparities because we have mis identified the source of the violence. We place the violence on attributes because we can identify those human traits and we can count of how many times we see a pregnant woman die by the hands of her partner.  [00:33:15][29.2]

Speaker 2: [00:33:15] Right? You're looking for that.  [00:33:17][1.3]

Speaker 1: [00:33:17] You know, we can we can  [00:33:18][0.8]

Speaker 2: [00:33:18] look at correlation yield correlation. That's right. We can look at correlation because  [00:33:21][2.8]

Speaker 1: [00:33:21] we've thought that we can't measure perpetrators behaviors. We can. We can.  [00:33:28][7.4]

Speaker 2: [00:33:29] But I think, you know, part of it for me, part of the answer in this is this is the third part of the, you know, the third section of this on this podcast is really is is using a mapping of perpetrators patterns to recontextualize, to reconnect, to make sense of why did this survivor stop going to her mental health team? Because again, I think part of it is is that again, for my my mental health and addiction colleagues, I think when we think very narrowly about trauma, which is the biggest land where most people will look and think about the way these lack of connected means, a lot of things they're often not thinking about things like is their current course of control that's interfering with my client, getting to her appointment. Right? You know, and and how am I going to assess for that? How am I going to write that up? If she stops coming, I'm going to write it as she became noncompliant? Or am I going to be able to write up and say that I'm suspect, but don't know that based on statements that she made to me that her partner may be interfering with her attending sessions?  [00:34:36][66.8]

Speaker 1: [00:34:37] So I'm going, I'm going to I'm going to use a little bit of a, you know, analogy here. If you are a. Professional working with a person who has had trauma because they experienced an earthquake. You will have a specific strategy you may use for their treatment plan. If you have a person who is in your office who is experiencing trauma because they live in the land of continuous earthquakes. You are going to have a very different strategy.  [00:35:12][34.9]

Speaker 2: [00:35:13] I love it, I love, I love that. I love you. You're going to start thinking about the source of the earthquake, right? Yeah.  [00:35:19][5.6]

Speaker 1: [00:35:20] Or you're going to say, OK, well, let's talk about, you know, how do we? And it can't just be leave, right? Don't jump to just leave, right? Right. You have to understand all of the behaviors in the entrapment and that.  [00:35:31][11.1]

Speaker 2: [00:35:31] But your point is well taken, which is, you know, if it's post and it was a car accident, let's use a car accident. It was a car accident, right? You know, and somebody was traumatized by a car accident. You would be treating it differently than if somebody was trying to ram this person's car every day, every single day, every single day. And and you would be you would treat it as a safety issue.  [00:35:53][21.5]

Speaker 1: [00:35:53] Not a medical is never held accountable.  [00:35:55][1.4]

Speaker 2: [00:35:55] That's right. And this is a  [00:35:57][2.0]

Speaker 1: [00:35:57] random person trying to ram you with the car and nobody was doing anything. I mean, how ridiculous is that?  [00:36:03][5.7]

Speaker 2: [00:36:03] You know, people know people are coming along with us on this right now. But it it is true that, you know, one kind of pointed out that there's it's really clear there's a real safety issue. There's a real external threat.  [00:36:15][12.0]

Speaker 1: [00:36:16] And so but it's also the ongoing reality throughout the fact that the threat is not addressed by other people. You know, it's it's really it's really impactful to one's mental health. Right? When the reality of the perpetrator is not seen nor addressed by anyone around them.  [00:36:36][19.8]

Speaker 2: [00:36:36] Right. And so part of it is is one really basic thing is is and you can start with them. And I'm speaking to mental health colleagues, you know, which is if you've got somebody who is a trauma survivor, you're treating them for anxiety, depression, PTSD really do a thorough assessment of the ongoing current existing ongoing dynamics of coercive control  [00:36:59][22.5]

Speaker 1: [00:36:59] and do not say leave. Say, how can I help you? Well, if  [00:37:03][3.8]

Speaker 2: [00:37:03] before you get, how  [00:37:04][0.7]

Speaker 1: [00:37:04] can I? Well, how can I assist you in light of your situation and the perpetrators patterns of behavior?  [00:37:10][5.3]

Speaker 2: [00:37:10] You're assuming that we've gotten there ready, which is which is to understand that, you know, I think a lot of times people think, well, relationships are over, and I've actually heard this from very high level colleagues. I respect who do work with kids where they said, Well, we only work with families and kids, mothers and kids. Post-Separation know as if that that there was some magic delineation between that moment of the couple being together, living together and post. And so there is  [00:37:36][25.8]

Speaker 1: [00:37:36] obvious reductions in the intensity of violence. You know, of most perpetrators de-escalate a lot of physical violence when they're no longer in control of you. Some escalate.  [00:37:49][13.2]

Speaker 2: [00:37:50] Their physical violence escalated, presumably.  [00:37:51][1.2]

Speaker 1: [00:37:52] But you know, this is where understanding their pattern will really assist you and not asking questions like, do you feel in danger? That is not the question that you should be asking. That is because that's way too vague. It doesn't. It doesn't get at the pattern of coercive control.  [00:38:12][20.4]

Speaker 2: [00:38:13] I want to understand your partner's pattern of behavior. You know, their violence, their control, their abuse when you were together. And I'd like to know more about how it's evolved and changed as you have separated or how not.  [00:38:28][14.9]

Speaker 1: [00:38:28] Not just that. A really good question to ask people is how their perpetrator responds to boundaries, putting up right to accountability, right to naming what they did, to pointing out that it harmed their children. What is their response to that? Do they double down? Do they become more violent? Do they threaten more when that happens? Do they threaten just the family members or do they threaten professionals? Do they call professional organizations and make threats because a mental health practitioner is holding them accountable and telling them that their behavioral choices are the source of their relationship breakdown and their children's anxiety and their learning disabilities and their own mental health issues? So what is the response to that?  [00:39:21][53.0]

Speaker 2: [00:39:22] So, right, so this is about assessing, you know, in a clinical setting for coercive control and the ongoing influence of a perpetrator who's not in the room with you. You may be seeing with this woman or this woman and her kids or their kids. And it's a way to really understand, you know, and look for the ongoing influence, the ongoing contributions that person who is abusive is making to the situation and contextualizing the survivors response, contextualizing the survivor's inability to sleep. Maybe it's not a sleep disorder. Maybe it's genuine fear that my kids are going to be taken away from me by a court that's not really seeing what's going on, and the perpetrators are really committed to hurting me. You know, it's maybe  [00:40:05][43.3]

Speaker 1: [00:40:05] it's anxiety about having to get up the next day. Take care of children with somebody who may scream and yell and demean you and threaten you.  [00:40:15][9.1]

Speaker 2: [00:40:15] That's right. And so I think when we we we look at this, we have the ability as mental health professionals and addiction professionals to really start being more thoughtful about how we we assess for current coercive control and how we document it and then how we report it out to anybody we're reporting out to, to be  [00:40:33][18.2]

Speaker 1: [00:40:33] honest with you as a survivor. Here is how I would like to have had my mental health type diagnoses documented. I would have liked the mental health practitioner to ask me about the circumstances of my life in order to understand what contributed to that diagnosis. I would like for them to document the behaviors of my perpetrators in order to explain the normal, understandable biological responses and hormonal responses to that trauma. I would like them to place the responsibility of that ever correlated. Or understood as being contributory or is a primary cause for that diagnosis. And I would like for them to document my resiliency and my strength. In the face of that challenge, which I did not choose. That's what I want Mike Trump.  [00:41:42][68.9]

Speaker 2: [00:41:43] Boom, boom. No, I think that was so clear, and I think it's it's for anybody listening it, it really breaks down the bits and pieces you know about what a good domestic violence informed response to this and and how this. Protects survivors and protects professionals from the weaponization of mental health and addiction issues, because that protection against weaponization isn't just in the way you talk to a survivor. Yeah, it's about the way you name it and the documentation. It's the way you communicate it back to the courts or child protection and point them in the direction and say, Look, this is somebody who is having a normal human response. Yeah, to these behaviors that have been directed to them. Right.  [00:42:30][46.8]

Speaker 1: [00:42:30] Also, I believe that in those type of diagnostic situations, that it is the responsibility of the diagnostician to clearly and firmly state in their documentation that a diagnosis of PTSD with domestic violence involved families does not constitute a judgment about parenting. That is outside their scope of expertize.  [00:42:57][27.0]

Speaker 2: [00:42:59] Right? And I've seen this, you know, actually wonderfully the impact of mapping perpetrators patterns of fit together. You know, I heard from a court evaluator, they were discussing a case and they said, you know, once I contextualize this mother's addiction back to the perpetrators behavior and realizing now that they're separated. Instead of wanting to remove the kid from her, I now want to look at this and say, Oh, let me, she should get a chance to be in treatment. Never kids. It was a very tangible change when it was recontextualize back to the proposed behavior. Right? So, so  [00:43:32][33.9]

Speaker 1: [00:43:33] and obviously, there's one there's one other piece of this that's super important. And you know, we're just talking about mental health. But the reality is, is that we need to fund the programs that support survivors. We have to fund housing initiatives. We have to fund good behavior change initiatives that actually hold the perpetrator accountable in an ongoing way, according to the danger that they've presented to their family based on that assessment of their patterns. We have to do the things we have to invest in, the things we have to invest in the tools.  [00:44:04][30.7]

Speaker 2: [00:44:05] One of my my favorite stories about how this can change things was a case dealt with years ago, which involved a dad is find her mom, who was was profoundly depressed, not getting out of bed, and the kid went to school and reported both those things and and the response from child protection was very domestic violence informed. I won't I won't give all the details of it, but they they they really partnered with her that mother's depression lifted without any treatment, right? Because it's the situation. That's right. It was it was a choice. It was a situational depression. Yeah, that was a result of not being supported, not being partnered with and nobody taking her partner's violence seriously. Yeah. And a professional came in and did all those things and partnered with her beautifully. And her depression lifted.  [00:44:54][49.1]

Speaker 1: [00:44:55] That's because when we were acknowledged and people do their job and they hold the person who's holding us accountable. Amazing things. That's right. And then all collectively have the energy to care for children appropriately and take care of our families.  [00:45:09][14.9]

Speaker 2: [00:45:10] And one of the things that we recommend again is mapping perpetrators pattern, which includes the intersections with mental health and addiction issues. And again, I'm thinking about another example where we're a mental health clinician to this with the survivor, and she felt tremendously validated in some sense. All you need to do is think about mapping is, is is about witnessing is about deep listening is is really about it's  [00:45:35][24.3]

Speaker 1: [00:45:35] about honoring what really is  [00:45:36][1.2]

Speaker 2: [00:45:37] honor what really is and and not getting caught up in professional jargon. And instead of these theories, but really looking behaviorally and family functioning wise, what's going on?  [00:45:48][11.5]

Speaker 1: [00:45:49] Yeah. And I think that your model is brilliant and that you've done something really amazing by clearing away a lot of the crap that people focus on and just looking at the behaviors and they're in, you know, the influence that they have on on child and family functioning and well-being in the family and just really saying and naming those behaviors as being destructive and problematic, offering people solutions for how they can hold that accountable and change that. Is really foundationally the most important thing. We can talk all about serious of parenting series of relationships, and we can come up with all sorts of words that are actually meaningless because really the thing that matters is that my interaction with you should be nourishing and safe and supportive. If I'm your partner. If I'm doing actions which are harmful and destructive, cause fear and trauma and remove your liberties. Then I am not. Engaging you in a legal or responsible way that's going to help continue our relationship and raise responsible loving children. And if nobody holds those behaviors accountable and names them as problematic and if everybody around is afraid to name that and say, Oh, well, they're really good, they're really good parents, they love you anyway, obey them, do what they say, forgive them. Even though they're still behaving that way. Then children learn that those those are social agreements. That we agree as a society that those behaviors are OK. And that that person has the entitlement and permission to engage in them, and therefore they do too. And they will emulate them and they will reflect them, and they will use similar strategies to get what they want as they age. And that will get compounded to age with trauma because it twists a person. It actually destroys their internal integrity. To not be held accountable and for us not to put boundaries around it. And for nobody to name it, it creates a form of psychosis. That believes that violence is a legitimate tool for nurturance. And it's not.  [00:48:38][168.7]

Speaker 2: [00:48:43] I think there was a really well in and I think when you referred back to the models being brilliant, I think all I'm trying to do is is really be an honest conduit for survivors experiences into the professional environment.  [00:48:59][16.6]

Speaker 1: [00:49:00] I love you for that.  [00:49:01][0.9]

Speaker 2: [00:49:02] That's what I want to do. You know, and and I think professionals. I want to help us get out of our own way to listen. Just see us to see to see survivors and to see perpetrators.  [00:49:18][16.6]

Speaker 1: [00:49:19] If you have never had to throw your body between another person and a child, then you don't see me right? You don't. If you've never had to take that either emotional or verbal violence and try to stand between it. Day after day, well, everybody says that that person is great while you go to your faith leaders and they say stay and they say fight for your relationship and, you know, make your family intact and forgive and do this and do that and and you don't experience all of that and you don't ask then you don't see. That's right.  [00:50:01][41.1]

Speaker 2: [00:50:02] And the doorway we're opening for for professionals is ask. Listen, if you're a mental health or addiction professional or work for an agency in that area, think about what it means to become domestic violence informed. You know, to start thinking about how do we build in assessments for coercive control throughout our programing? How do we give guidance to our staff about how to document when we're dealing with somebody who does have anxiety or depression or  [00:50:31][29.6]

Speaker 1: [00:50:32] bipolar disorder or just Operation Defiance disorder?  [00:50:36][3.8]

Speaker 2: [00:50:36] That's right. Or somebody who has real other mental health issues, you know, schizophrenia, how they're being controlled or being abused by somebody. How do you document that? How do you describe how somebody uses medication to control somebody? And you know, the medical profession gives this person who's abuse of control over this person's medication?  [00:50:57][20.8]

Speaker 1: [00:50:58] What's what's the what's the influence on a child's ADHD or learning disabilities if they have a parent at home who's domestically violent or coercive controlling and also is abusing the children? That's right. What's what is what is the impact to a child that already has disabilities and maybe on the spectrum?  [00:51:21][23.6]

Speaker 2: [00:51:22] And that's and that's even a bigger area. You know that the that the contextualization of children's behavioral health and mental health and educational issues from perpetrator's parent is a behavior. And so we could even expand this out to our educational colleagues and school counselors. And, you know, think about coercive control. Think about the connections. Think about those patterns. Look for them. Screen for them across different scenarios right now.  [00:51:49][26.8]

Speaker 1: [00:51:50] And just even think about schools and how poorly they do around, you know, the anti-bullying campaigns, you know, they create the buddy bench so people will never feel alone, right? But they will not. They will not have.  [00:52:04][14.1]

Speaker 2: [00:52:04] I've told our kids, never told anybody that we had a funny man and we have one of our children do not do the body as like putting a target on your back.  [00:52:12][7.7]

Speaker 1: [00:52:14] We're kid. But, you know, I just I feel like we really fall down in in really seeing, you know, when we have recently, you know, we had an incident in our town where there was a credible threat to the school with gun violence. Well, the whole family had illegal guns and the whole family had issues with violence. Where do you think that kid learned that? I know we're not responsible for all of our children's development and that our children sometimes have things they come in very mysteriously with, that's not of our making. But we have to start looking at the links between violence in our schools, sexual violence in our schools, bullying in our schools and domestic and sexual violence at home. We have to.  [00:53:08][53.9]

Speaker 2: [00:53:08] So we're going to move to wrapping up and I'm going to summarize, you know, five strategies that we've talked about here that can really help people in clinical settings start thinking about how do you make your domestic violence, make your clinical practice more domestic violence informed map perpetrators patterns? You know, really, it's really basic. You know, we're going to be having our our mapping tool move online in a couple of months and you build access directly. So. But now if you take our core training, you can access that mapping tool. So that's one thing. Just improve clinical practice to be more inclusive of dynamics, of course, control. So we've just been talking a lot about assessment planning to ensure access to treatment. You know, is anybody getting in the way of you getting here and, you know, asking if the diagnosis, the treatment that the documentation is going to be used against somebody or they're worried it could be used against them because they're afraid? Yeah, they're afraid of that. And how can you help them communicate things like their parenting or their their their the context of the abuse? For whatever issue they have, so really strategize and partner with that client around what's going on outside the four walls for what's the clinical setting. I mean, that to me is is is so  [00:54:28][79.8]

Speaker 1: [00:54:28] critical so that your documentation that you're aware that your documentation is going to be used in ways that you don't intend it to be. That's right. And you really need to protect your your clients from that abuse step that post-separation use of their mental health in other settings.  [00:54:47][18.7]

Speaker 2: [00:54:48] And you do deserve, if you're that clinician to be supported by your agency because being more forward on the front foot on this issue may make you more of a target from the perpetrator. Absolutely, and needs support from  [00:54:59][11.5]

Speaker 1: [00:55:00] supervisors, managers and also from your professional organizations. And you know, one of the best way to protect yourself against false allegations, even in that setting as a professional is to very well document everything. That's right,  [00:55:16][16.5]

Speaker 2: [00:55:17] and we're not and we're not talking just about physical violence. We're talking about threats to sue, threats to make complaints are those things, you know, just so so we're really kind of  [00:55:26][8.8]

Speaker 1: [00:55:26] clear take children.  [00:55:27][0.4]

Speaker 2: [00:55:28] Yeah, yeah. All of those things, the shared framework of safe and the other can really be helpful because we're talking through a perpetrator, pat and lens. And if that's being used by child protection and mental health practitioners, that can really help bridge the gap look to make your agency domestic violence informed, you know, really go all in. We're so proud of Odyssey House in Victoria and Australia. First, domestic violence informed addiction agency. Maybe in the entire the entire world. That's right. And they're working towards that right now, too. And then last thing you know, which is a little more kind of amorphous, but, you know, work to change cultural attitudes about gender addiction and mental health. You know where you really need to slow down these conversations and really ask how we're holding women and men to different standards around these issues? And and really unpacking these stereotypes that that women are, you know, are are less emotionally stable, which is part of which makes us weaponization possible and to really challenge these things and to really start thinking about how someone who's getting violent and getting abusive as yelling and screaming and crying people names that maybe we need to rethink the way we think about their stability and and their the way they put things together and really so obvious it does, doesn't it?  [00:56:47][79.1]

Speaker 1: [00:56:47] You really work. You have to work hard to suspend this reality, right? I think we worked collectively hard to suspend this reality for a long time. And really, I would hope and envision a future where a collective of mental health practitioners gets together to really review and look honestly at the structural inequalities and biases of their own practice.  [00:57:16][28.9]

Speaker 2: [00:57:18] That's great. I think that's a great idea. So this really brings us to the end of this podcast, but not to the end of our discussion of this topic. We may revisit it again, we may raise it again, but  [00:57:29][10.4]

Speaker 1: [00:57:29] I'm encouraging any mental health professionals you know, who have thoughts on this to to contact us because we would love to have you on our show,  [00:57:36][6.7]

Speaker 2: [00:57:36] right? You can reach me at David Mandel at Safe and Together Institute.  [00:57:39][3.1]

Speaker 1: [00:57:40] Yeah, you can reach me at Rustan's. At Safe and to. Other institute?  [00:57:43][3.3]

Speaker 2: [00:57:45] That's right. And so if you like to show, if you are following us, follow us on on your platforms that you're listening to, share it on all sorts of social media. I am spending time on Twitter at your encouragement. I'm hoping today that I'm going to reach a thousand followers, which pales in comparison to the number of followers. You know,  [00:58:08][23.4]

Speaker 1: [00:58:09] it's it's it's good. You know, I don't accept this thing that says that the internets are a problem. The internet saved my life because I'm a survivor and I get to touch other people outside my very, very isolated world, and we need to frame the discussion. And I'm so proud of you for being on there and stepping out of your comfort zone.  [00:58:29][20.7]

Speaker 2: [00:58:30] Except they described my Twitter handle as a hashtag of the day.  [00:58:32][2.6]

Speaker 1: [00:58:33] Everybody learns and grows.  [00:58:34][1.0]

Speaker 2: [00:58:35] So anyway, so it's David Mandel or at David T. Mandel. If you want to follow me on Twitter  [00:58:40][4.9]

Speaker 1: [00:58:41] and miners at Survivor, a strong three.  [00:58:43][1.9]

Speaker 2: [00:58:43] So that's right, and the podcast Twitter handle is  [00:58:46][2.8]

Speaker 1: [00:58:47] P.W. As  [00:58:48][0.9]

Speaker 2: [00:58:49] part of our podcast, you  [00:58:53][3.9]

Speaker 1: [00:58:53] partnered with  [00:58:54][0.4]

Speaker 2: [00:58:54] the stars, partnered with Survivre. That's that's a little bad that we both don't know what it is. So anyway, so if you want to check up on the safety of their institute, go to safety either in sitcom  [00:59:02][8.5]

Speaker 1: [00:59:03] or Academy Dot Saving Together Institute dot com, which is where we have many of our paid and free trainings.  [00:59:09][6.0]

Speaker 2: [00:59:10] And there is an entire online course on intersections of domestic violence, mental health and addiction, where some of these ideas are covered more in-depth with with different angles and more practical ideas about practice. So if you if you really like this, you know that's another place to go. And I think we've come to the point where we say, and we're out, we're out.  [00:59:10][0.0]

[3424.0]