By Mary Knight, MSW
About the creator: Mary Knight, Filmmaker and Survivor reveals the role a church played in her trafficking as a young girl.
This blog post was originally part of our 2016 JuST Conference Speaker Blog Series.
The Connection Between Dissociative Identity Disorder and Sex Trafficking
By Lisa Cruz, RN-C MNN
Dissociative Identity Disorder is commonly called Multiple Personality Disorder. The disorder is generally misunderstood and often sensationally or inaccurately depicted in the media. However, did you know numerous studies have shown 1-3% of the general population meets the diagnostic criteria for Dissociative Identity Disorder?
Dissociative disorders occur on a spectrum, ranging from mild to severe. The spectrum begins with normal dissociation and is followed by dissociative amnesia. The more familiar and widely known Post-Traumatic Stress Disorder (PTSD) falls into the middle range of the dissociative disorders spectrum. Lastly, the most complex dissociative disorder is Dissociative Identity Disorder (DID).
One of the most common causes of Dissociative Identity Disorder (DID) is childhood sexual abuse. When a child experiences a stressful event such as sexual abuse, the fight-or-flight response is activated. Dissociation is a way of escaping psychologically when the child cannot escape physically. The child’s only escape may be to pretend the abuse is happening to someone else or another “part” of themselves. If the sexual abuse is severe and prolonged, the “part” the child repeatedly escapes to may develop its own identity, becoming completely separate from the child’s conscious and accessible memory.
DID is the result of creativity, intelligence, strength and the desire to survive – not a mental weakness or illness. DID can be healed through therapy and the integration of the separate “parts” into a new and whole self. However, if the disorder remains undiagnosed or misdiagnosed, the person cannot be helped or healed.
Trauma survivors may only have symptoms instead of memories. Many people with DID report memories of childhood trauma and obvious symptoms, such as “coming to” in an unfamiliar place or meeting unfamiliar people who know them, but as a different name. However, it is not uncommon for people to not be able to recall memories of their childhood trauma, yet still display the more subtle and harder to recognize symptoms of PTSD and DID. These symptoms can include unexplainable feelings of guilt, shame and worthlessness, unexplainable feelings of emotional numbness and detachment, mood issues, difficulty concentrating, thought insertion, depersonalization, derealization and more. Since there are no known traumatic memories to attribute the symptoms to though, the person is often misdiagnosed and only treated for surface issues, masking their true needs. When this happens, the opportunity to help bring healing and restoration to the person is missed.
It is especially important for those working with sex trafficking victims to be aware of dissociative disorders. Many trafficking victims have a history of childhood sexual abuse, a leading cause of PTSD and DID. Additionally, studies have shown women in prostitution experience the same level of PTSD as combat veterans. Furthermore, studies have shown that 35% of prostituted people and 80% of exotic dancers experience dissociative disorders. In fact, studies have shown that 5-18% of prostituted people and 35% of exotic dancers meet the diagnostic criteria for DID.
However, the situation is far from hopeless. With proper diagnosis and help, a person can heal from dissociative disorders. In fact, there is a phenomenon called Post-Traumatic Growth. Trauma survivors can even become stronger and create a more meaningful life. They don’t just bounce back—that would be resilience— they actually bounce higher than they ever did before.
About the author: Lisa Cruz has experienced Post-Traumatic Growth after surviving child sex trafficking and Dissociative Identity Disorder. Lisa has been a Registered Nurse for 23 years and is the founder of Nurses Against Trafficking.
This blog post was originally part of our 2016 JuST Conference Speaker Blog Series.
The Role of Child Advocacy Centers in Sex Trafficking Cases
By Iona Rudisill, Baltimore Child Abuse Center
I became a nurse because when I was ten years old I went to a doctor who missed the signs, and that was my last chance at telling someone about what was going on in my life. My last thought was, ‘Maybe somebody could rescue me. Maybe I could have a different life.’ When that guy missed the signs, it devastated me…I just decided what would have made a difference for me—and that was the medical professionals.
–Jen Spry, RN and survivor of human trafficking
The sex trafficking of juveniles is now recognized as a critical public health concern. The burden of identifying, referring and treating victims requires multidisciplinary education for health care providers and a coordinated community response, one that Child Advocacy Centers nationwide are prepared to provide. In 1987, Baltimore Child Abuse Center (BCAC) was the first Child Advocacy Center (CAC) developed in the State of Maryland, and for decades BCAC has been providing a resource to the community with a comprehensive approach for youth who have personally experienced sexual trauma and witnessed various forms of violence. BCAC is an accredited Child Advocacy Center that understands when providing services to youth who have been trafficked or are highly vulnerable to being trafficked, a holistic response (i.e. forensic interviews, treatment, advocacy, healthcare) is needed – from prevention to aftercare for youth and their families. Given their background and experience in trauma-focused and multidisciplinary approaches, CACs can provide an excellent healthcare response for DMST cases. BCAC as well as some other CACs have board-certified forensic pediatricians as part of their multidisciplinary team. This forensic pediatrician collaborates with medical and non-medical colleagues regarding multiple public health care needs such as malnutrition, tattoo removal, forced pregnancies, substance abuse, mental health diagnosis, visionary problems, dental care and burns. These healthcare risks can leave a permanent scar on the life of a youth, if mishandled or overlooked. Therefore, Child Advocacy Centers are an essential component in providing a necessary healthcare response in the best interest of the youth by performing such medical procedures as non-acute forensic examinations and testing for STIs, as well as healthcare education and necessary referrals.
Collection of forensic evidence in acute cases (sexual violations occurring within 72 hours) may be challenging in the CAC setting due to the extensive time involved in conducting these evaluations and the need for physicians who are comfortable with and experienced in doing these exams. Even if CACs do not have the personnel, space or time to complete these acute examinations, being able to refer to another healthcare provider is a necessity. BCAC has addressed this through an active partnership with Mercy Medical Center in Baltimore, MD that is equipped to provide Sexual Assault Forensic Examinations (SAFE) for acute sexual abuse and assault cases, which would include DMST. Therefore, Law Enforcement and Child Protective Services investigators could transport a child who has received a forensic interview to Mercy for a forensic examination, which would provide the space, equipment and personnel to collect necessary evidence for their investigations.
The healthcare response in a CAC helps to provide consistency for a youth who has experienced DMST because they won’t have to travel to different places or be interviewed by different professionals, who all want to provide the necessary care for them. Therefore, ensuring that CACs have the critical resources and healthcare providers on staff who have knowledge about the multiple dynamics involved in these case investigations is essential. Overall, it is vital that health professionals of all branches receive the training and education needed to address the complexities of human trafficking.
In response to this need, Shared Hope International recently released i:CARE, a guide for health care providers to recognize and care for victims of domestic minor sex trafficking. Resources like this one are so important in advancing the knowledge needed to improve the responses to juvenile sex trafficking. If the doctor who missed the signs in Jen Spry, the survivor quoted above, had been trained, and had the support of other trained professionals in the medical community, she might have been saved from further abuse and might have received the specialized treatment victims of child sex trafficking require.
i:CARE was written in collaboration with physicians, psychologists, nurses, professors, experts and survivors of trafficking, and is accompanied by four short training videos. Visit the Shared Hope Store online to purchase your copy of i:CARE today.
The Faith in Action Kit Opens Doors
From Beth in California
As an Ambassador for Shared Hope International in the Bay Area of California, I have found that those most interested in having awareness presentations are church groups, so the Faith in Action Kits resonates with their interest.
I was privileged to have been sponsored by the United Methodist Women (UMW), California-Nevada Region, to have a SHI booth at the worldwide UMC General Conference in Portland this past April. My relationship with the United Methodist Church began about a year and a half ago. Within five minutes of my arrival at the conference Shared Hope booth, the Bishop for that region showed up. We had met only briefly before, but Bishop Brown began our conversation with, “I’ve been looking everywhere for you.” Kismet! And music to my ears!
I showed him the brochures and resources at our table, including the Faith in Action kit. Then I began to load him up with an armful of materials as I shared stories of our work. I knew Linda Smith wouldn’t mind if I gifted him with her book, Renting Lacy.
He was very interested in the faith-based materials and informed me that, upon his retirement this fall, he plans to train pastors using the Faith in Action kits to effectively speak and preach on the issue of sex trafficking. My reply?
“Well then, give me back all that stuff and I will MAIL YOU every single tool you will need to in order to do that, including a Faith In Action Kit. And I will come and train you!”
He is going to get permission from his leadership and then we’ll get started. I can’t tell you how exciting this is!
At the moment of this writing, I’m here at the California Nevada United Methodist Church Annual Conference working a Shared Hope booth, and Bishop Brown just walked by and shook my hand and thanked me for the packet! The new Faith in Action kit opens doors for us and all we have to do is walk through!
What Could I Do to Make a Difference?
A Guest Post from Shannon in Virginia.
When I became an Ambassador of Hope, I was passionate about spreading awareness of trafficking in my native state of West Virginia. Nestled in the Appalachian Mountains, surrounded by rich natural and cultural resources, it is easy to feel you are far away from the rest of the world. Unfortunately, West Virginia struggles with real world problems, such as severe poverty, drug use and unemployment. I grew up knowing the state I loved lagged behind others in economic growth and the health of its citizens. As I became involved in combatting sex trafficking, it broke my heart to find out that West Virginia also lagged behind in its laws to protect victims and bring justice to the people who exploit them.
As I began encouraging citizens and legislators to ask for stronger laws to protect their children, I have been honored to work with advocates and everyday citizens to educate West Virginians about the topic and ways that they can take action. In a recent visit, I spoke to a roller derby group about warning signs of trafficking while they are on the road traveling to competitions, worked with a women’s organization to hold a community screening of our prevention film Chosen, and was a guest on a radio show to talk about how West Virginia can strengthen its laws.
I was especially humbled to speak to a group of law enforcement officers, child and victim advocates in my hometown. These men and women are on the front lines of the issue and work hard to protect vulnerable populations from people who hurt them. It was exciting to meet the West Virginia State Police corporal (pictured here on the right) that had successfully worked a case I often use to illustrate that trafficking does not have to involve money, but that it can be anything of value exchanged for sexual acts. In this case, a man solicited elementary-age victims over the Internet and lured them with Ugg boots and cigarettes. The perpetrator received a long prison sentence and will be unable to harm other children in the community. Read the story here.
Though West Virginia struggles with issues that make it vulnerable to trafficking, it has heroes like this officer, concerned citizens and legislators that continue to sponsor and push for stronger laws against trafficking. They all recognize that there is a need for awareness and are constantly working to ensure West Virginia lives up to its state motto, “Mountaineers Are Always Free.” I am happy to do my small part.
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