Sci-Tea Talks IPV: Exploring types of abuse and their association with PTSD

Welcome to the 6th episode of Sci-Tea!

Join us (Ryan & Nanci) for a conversation with Dr. Beth McGee and Dr. Ryan Couillou on Friday, September 16th for a discussion on intimate partner violence (IPV) and posttraumatic stress disorder (PTSD). We first talked about a paper that our guest Andy Godfrey recently published titled “Examining the Associations Between Multi-Dimensional Facets of Emotional Abuse and Posttraumatic Stress Disorder Among Trauma Exposed Women.” We cover the definitions of emotional abuse and different facets of emotional abuse that are closely tied to the development of PTSD. We also get the valuable perspective of our guest Dr. Debbie Easterling, who worked as a grant writer for an organization, My Sister's House that provides resources and safety with the goal of ending the cycle of domestic violence. Andy's research leads us to focus on the harmful effects of isolation in the context of intimate partner violence - a theme that Dr. Easterling also emphasizes. We wrap up by talking about how common and misunderstood both emotional and physical abuse are and how respected community members may be able to be allies if given training.

✨ Dr. Debbie Easterling discusses her work as a Grant Writer for My Sister's House, an organization she worked with for over 6 years. This organization aims to end the cycle of domestic violence through its services. We learn more about these services and Dr. Easterling dispels familiar narratives about intimate partner violence and provides insights into themes of Andy's research based on her experiences. Dr. Easterling is now an End-of-Life Doula and was previously a faculty member at both Bryant University and Salisbury Unversity.

✨ Donald (Andy) Godfrey is a Ph.D. Student at the University of Houston working with Dr. Julia Babcock to study emotions and family conflict. Andy's research includes a focus on emotion dysregulation and using psychophysiological tools to understand aggression.

Materials Referenced in this Episode:
✨ Andy's research paper: https://link.springer.com/article/10.1007/s10896-022-00429-y
✨ My Sister's House website: https://www.mysistershouse.org/
✨ Recognizing a domestic violence situation, how to get help, and how to help a friend: https://www.patreon.com/posts/conversation-lee-71990468?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=postshare_fan

Connect with Ryan on Twitter, Instagram, or TikTok for more content like this: https://www.ryanlinnbrown.com/links

Transcript

Ryan: Hey y'all, I'm Ryan

Nanci: and I'm Nanci. And this is Sci-Tea, where we bring you engaging conversations between researchers and practitioners. 

Ryan: We feature leading experts as well as early career researchers in psychology and beyond, we will be speaking with other professionals working in settings such as hospitals, schools, and governmental agencies. 

Nanci: So, grab your tea 

Ryan: or drink of choice 

Nanci: and enjoy the conversation!

 Ryan: Welcome to Sci-Tea today, and I'm so excited to start off by introducing my good friend, Andy Godfrey. And Andy Godfrey is an instructor and graduate student at the University of Houston. He studies social behavioral neuroscience and teaches in the psychology department and a lot of his research, focuses on family conflict or violence, and the effect that it has on psychological development, and Mr. Godfrey has also spent time as a lab manager for the personality emotion, brain, and behavior Lab at the University of Utah. And he has also done research on the different factors that contribute to maladaptive Behavior including various forms of abuse. And he’s also interested in individuals, empathetic responses. And he was a huge help to me when I was writing my very first ever Grant and really interested in his works. I just appreciate him as a human and as someone who's on the episode today, so welcome Andy.

 Nanci: that's good. Right? And I would like to introduce our other guest. Dr. Debbie Easterling. She is currently a grant writer at My Sister's House, located in Charleston, South Carolina. This is a domestic violence agency, providing extensive Services, advocacy, and education around the of interpersonal violence Debbie is also volunteer board member for this agency crisis line and a court advocacy sectors. Debbie has earned her PhD in Business Administration at Louisiana State University. She was a professor associate Dean and chair of the management and marketing department at Salisbury University. But before that she was my colleague, at Bryant University, we started the same year at Bryant after we got our Doctorate Degrees and this is where we first became fast, friends. and I am so grateful that our friendship has continued and grown ever since, welcome Debbie. 

Debbie: Thank you.

Ryan: and I'm really pumped that we get to talk about some of the Andy’s research today. So, the specific study that we're looking Andy and his colleagues examined the relationship between emotional abuse and post-traumatic stress disorder or PTSD. And how specific facets of emotional abuse, may relate to PTSD symptom severity for women who have experienced trauma. And so specifically, they were interested in looking at how these Dynamics unfold within couples, and they recruited 141 couples with trauma exposed women who completed self-reports of physical and emotional victimization and perpetration in their current relationship and reported on their own PTSD symptom severity. And so, they found overall that about 15 percent of the variance in PTSD symptom severity was due to emotional abuse as well as some more nuanced findings around the specific components of emotional abuse that we’ll talk through in this conversation. So, there are a lot of big picture implications from this study and I'm excited to talk about all of them, but I definitely want to make sure, and Nanci and I want to make sure that y'all feel free to ask each other questions, but first Andy, I just wanted to see, can you tell us sort Of your biggest takeaway from doing this kind of work that you've been doing throughout grad school?

Andy: All the work?

Ryan: or this paper as well. 

Andy: Yeah. I mean, I’ve really started to zone in on some of the specific behaviors that we see in emotional abuse and really kind of opening up the depth of what intimate partner violence to looks like, because obviously, when we think of intimate partner violence domestic abuse, we think of really intense physical acts against intimate partners, which is absolutely true. It's part of it. But there's a lot of depth to what that can look like from relationship to relationship. And as far as the context in which this aggression is happening. So, looking at these different aspects of emotional abuse gives us a lot of a lot more information to work with as regarding the, you know, the specific environment. What's being said, what kind of actual emotions are being put onto this abuse. So, the more specific we can get with it when we're seeing emotional abuse, the better. And we'll talk a bit more about that. What that exactly means. But you just get a lot more information when we start looking at the specific kind of dynamics between partners as opposed to kind of broadly talking about abuse in a very specific way. 

Nanci: Well, I'm going to, before I jump in with a question for Debbie, follow up a little bit on that and Andy because that is looking at some of this paper and some of your other work. I just think that what you and your colleagues are doing, it’s incredibly ambitious and really important, of course, and one of Like at the basic level I just try to imagine. How do you know, getting people to come in? Because I know you’re having people do not just self-reports but there is sort of behavioral component you’re observing with individuals and couples together in a conflict kind of discussion. And that this paper was based on a study based on a larger project and just logistics, you know, of how do you, how do you make room for people to feel that they can actually do something like this. And I know there are some limitations that about safety issues too that some people are not included if it's not safe for them to be included. Can you speak a little bit about how you who the people are that you do collective data from? 

Andy: Yeah. Yeah, I'll start with that. So, one thing about, you know, are collecting data and recruiting individuals, for our samples is that there's really no like special tricks or kind of like nuances to it because I believe he’s actually very common, especially when we start talking about the specific emotional abuse dimensions. There are studies showing there’s a 12-month prevalence rate of around over 10%, both men and women who've experienced emotional abuse in the last 12 months. So, it's really just the community and recruiting individuals who are experiencing a lot of conflict within their relationship. Yes, not everybody meets criteria for our studies, but we find that, you know, our samples are more than we're able to get those samples without any problems. Because it's just so prevalent. And even speaking to kind of like the severe end of that, you know severe physical violence is more, people realize, I think the 12-month prevalence rate somewhere around two to three percent, but that’s still relatively large in terms of clinical studies and relative to if you were doing an experiment with or study on other populations psychopathology at two to three percent actually, a decently high number, as far as getting that recruitment level. So, there's not a lot of tricks to because it is very common again especially when you start talking about specifically emotional abuse. And as far as safety goes up, that is an important thing, but there's actually interesting studies showing that when we do conduct studies, with IPV, that include couples, people have tend to felt safe doing so, they felt to have found in the relationships that it’s beneficial to the relationships in some way so and of course there are safety measures making sure that the end of the study individuals, feel safe to go home, whether they feel that their interactions during the experiments have caused, some kind of increased conflict and risk for any kind of aggression, but with my lab that I'm currently with Dr. Babcock at the University of Houston, throughout her 30 years of having these studies, she's never had a single incident in which he's had to activate those certain protocols to make sure that people are safe because it's generally, it doesn’t happen despite having those safeguards protect participants. 

Nanci: Wow, that's fascinating. And I mean, there's a lot in there. What the what you said and on the one hand. I think it’s you know, it's sad that the prevalence rates are so high. I may be shocked by a probable Debbie won't be but on the other hand the fact that people who come in already, may be feeling some benefit by being a participant to me, that’s very powerful. So, that's really powerful. I’m just gonna shift gears a little bit and turn our attention over to our Debbie Easterling and ask you a little bit about My Sister's House and the work that you do and the work that is being done there. If you can fill us in a little bit about that.

Debbie: Yes, the work that I do is grant writing. So related to fundraising I write government grants Foundation grants to corporations, Local municipalities, I'm not in development. So, my background in Academia, writing papers, and doing research has really benefited m in the work that I'm doing now, prior to this I have been a volunteer on the crisis line, and I remain as a backup Crisis Line counselor. I’ve also done work in the court system. So, we at the agency, we see women that we see predominantly women that have left the abuser. We have a clinical Therapy Program for the community where we have over twelve hundred participants, you know, and that program and that occurs on zoom. And along as women have access to the internet, they can participate with that. Within our sheltering, we see women that are high lethality cases. So, women come in actually injured with broken jaws with burns with black eyes, with broken bones with disabilities from the physical abuse, and physical abuse generally, never occurs in the absence of emotional abuse, financial abuse, and isolation. So typically, it's gone on for some time. When they come into the agency into the shelter with their children, just to give you an idea of the agency, we typically have close 400 to individuals, each year, sheltering individuals, and we currently now have had to close our shelter due to the pandemic. South Carolina has a really high percentage of unvaccinated individuals, and our shelter are closed. We’ve been closed and open over the past year, but we, when that happens, we have to shelter our women in hotel rooms. So, to give you an idea of that we have approximately 15 rooms. Now, some mothers have up to three children ranging from 14 years down to six months. We have several women that have newborn infants in the hotel rooms. We have some Spanish-speaking individuals, and we currently don't have a bilingual staff member. So, we are relying on volunteers, to help them. So, you can just imagine school situations for the children how disruptive and unsettling it is. And most of the children back to Andy's work where he talked about four different dimensions that would be four different behaviors or phenomena that would lead to PTSD denigration. Many of these children have experienced that intimidation. They’ve experienced that they've experienced emotional isolation as well. So that is one of our biggest concerns, our children. 

Ryan: Absolutely, and I think that that is really inspiring to me, the kind of work that you're doing from the academic background now and just, I just applying that Grant those like grant writing skills to that area is awesome. And I'm just wondering sort of in your work around domestic violence, if you've come across or just realize sort of General myths, that we have around domestic violence and maybe who it who it happens to you, or the circumstances are what it looks like. If you've run into any of those that really stand out in your mind by any chance. 

Debbie: The predominant one is the thought well a woman could just leave. That is the number one. Why does she stay? Why doesn't she just leave? We had I'll just given you a quick example. We typically have an annual luncheon where we're able to have a great guest speaker. Someone who's written a book about domestic violence and their experiences, and we had it was really a high-ticket price a couple of years ago, so we had a number of varied participants. They were literally shocked that domestic violence happens to anyone that looks like us. They, that's a myth that it only happens to certain individuals and that if a woman wanted to leave that she had she could, why does she stay? There are lots of, there are lots of misconceptions really around domestic violence. But we have had a woman on the crisis line who was being strangled to death in serial strangulation that would ultimately result in her death. She could barely speak, her vocal cords have been damaged and she lived in absolutely the most affluent area of Charleston, South Carolina in a mansion, but was so isolated and had no access to resources or to other people that she is my prime example of how that misconception is just not accurate. 

Nanci: Thank you for sharing that, difficult realities, and truth. And there was a lot in there that you said, Debbie one thing that I'd like to maybe connect a little bit to with Andy's work and description of these different domains of emotional abuse in particular, this idea of isolation. And you know how powerful that can be like yours, you know, I can imagine that women being so isolated despite the fact that she of her living circumstances, and there were definitely some important associations to that isolation. And I, and maybe we can spend some time talking about it in both, the research realm, and also experienced lives. Andy did, when you hear, when you hear this kind of story, I know it's not unfamiliar to you because of who you're working with and can you maybe talk a little bit more about this particular, or you can talk about other parts of emotional abuse, the different factors, but, you know, how does this play out in the couples that you are studying. 

Andy: Yeah, well, specifically in regard to this study. We can actually look at kind of the weights that this different emotional abuse has as far as their association with PTSD symptom severity. And what's been shown not just in this study, but then in other studies, as well, is that at risk, the restricting engulfment’s This idea of cutting individuals off from societies and other resources. It tends to be the biggest influence even Beyond physical abuse. If we look at what we call the partial correlation in the study that partial correlation which is the strength between the emotional abuse and PTSD is strongest for short-term engulfment, even relative to physical abuse. So, having, it backs up, you know exactly what Dr. Easterling was saying is that you know that the isolation plays one of the biggest roles in outcomes related to psychological well-being, so that’s absolutely congruent.

Nanci: I also go ahead you go ahead. Go ahead, go. Debbie.

Debbie: About that, is, do you think that the strength of that association can be explained by just the longevity of isolation? So over time. I mean, you're in, you're out. It is experienced. Whereas physical violence. Let's say, Conversely, there may be several peak incidents and it’s and they almost seem like an apparition to a woman like, oh, I don't know how that happened to you just really flew off the handle or whatever. They sort of can explain them away or do explain them away. So, is that a valid interpretation of the results? 

Andy: Yeah, you know, one of the reasons that I kind of look more into emotional Aspect of it is the there’s more like, chronic numbness of the emotional abuse. It's not just like a single incident You are about. This is your day-to-day interactions how they're really like communicating with each other and forming their interpersonal environment, actually had this conversation with my advisor Dr. Babcock about how, you know, it's interesting that emotional abuse is just as strong of an influence association with PTSD and physical abuse, and, you know she agrees, she actually said something in the conversation similar to what you're saying is that you know, when somebody gets hit, they can kind of associate it, really with anything like, oh, you know, like they're having a bad day or they’re a jerk . You know, what, when emotional abuse is chronically at play starts to have more context or it gives interpretation to the pain, I guess, in a sense of it starts to build this idea of this is my fault, you know, this is 

Debbie: Yes.

Andy: I'm doing about this, it puts more again context to that, emotion to the pain again, with like, if you were hit, you could just kind of blame it on other things, or the other person. But the emotional abuse likely getting in on something more. I talked about this a little bit in the paper of what we call schemas or cognitions of essentially, how you view yourself and how you view the world when you're constantly surrounded by individuals who are denigrating you, and especially if you're cut out from other individuals who could give you other feedback, otherwise, you know, you're not an awful person. That isn't your fault. Cutting off that social tie is just going to and isolation more to this environment that's telling you, that's going to internalize the experience towards you as opposed to putting on some length and there is some research showing that I think it’s beliefs of guilt or fear kind of mediate that Association meaning, it causes that explain some of that variance between emotional abuse and in PTSD. There is some work on. It definitely is something to be looking to further why this exactly has this effect, but I think what you're talking about absolutely is related to kind of I guess that mediating factor between emotional negative outcomes. 

Debbie: Yes.

Nanci: you know, you're bringing that this concept of a sort of acute versus more chronic episodes. Not that the physical abuse can’t be chronic, but it also brings up how just how hard it would be, like to measure everything. Everything you want to measure, you know, I know that you in your studies, collect a lot of data. Different kinds of data. And it just this conversation just speaks to the challenge of trying to get even when you have a measure. You're measuring a frequency. Do we also get how long, you know you? I think it’s like in the last year, maybe you measure, but has this been going on longer? I just it's very complex and I, you know, I give you and your colleagues a lot of credit for coming up with the best design that is possible without wearing out your participants. And another thing that also comes to mind in this conversation and I'm kind of forgetting my thoughts 

Ryan: happen to us all

Nanci: happens to us all, there's just so much in there, you know, just has just this idea of the I mean if I can go back to isolation again; I feel like that. You know, Debbie is describing people that may, you know, that are in these extreme situations of isolation. And Andy is studying the people. And I wonder how much the people that Debbie is seeing is overlapping with the population that Andy is seeing and their related right to me in another they are not in completely different categories, but I'm wondering if they're in different phases or stages or something like that and I don't know if we could, you know, answer that question, but would it matter if they were? 

Debbie: I think it would matter. And I wanted to ask Andy about that as well. So, for I wanted to ask his opinion actually whether prolonged isolation and emotional abuse does lead to physical abuse. I can't see that, I was suspect that physical abuse, is that something has come before the physical abuse in general. Couples don't usually start out engaging in that kind of behavior with each other. So, I think that would be an interesting phenomenon to look at. Obviously, I don't think that you could predict a certain time period, but how do you see them related? 

Andy: There's absolutely data on psychological aggression and emotional abuse longitudinally, going becoming more physical over times that absolutely is there. And there's a lot of complexity to that still like less research on it because it does require longitudinal data designs. Just a lot more work than just getting a bunch of single day assessment. Right, as it looks, is requiring people to do stuff for years. There is a really interesting paper by a researcher up in Northeast, Dr. Kenneth Leonard I believe, showing that a lot of times abuse does start off kind of more unit-directional and it turns into more bi-directional over time. I think early on in marriages, there was more direction of violence of men towards women but that turned into more bi-directional, and it really makes it difficult to talk about it because we know self-defense violence is absolutely a theme. We're talking about IPV and these changes over time and how that is. It just like self-defense base. Obviously, you know, a large chunk of it is right, but I guess the bottom line is that it's really difficult to highest know what this point, but we know that there are changes in time but even If we know the changes in time, what is the context of that aggression? That or perpetrating, you know, is it actually some kind of actually becoming more aggressive with in of themselves or they are learning that aggression is the safest reaction to aggression, to defend, you know, it's just, it's just hard to understand what that Dynamic could even mean. So, I guess we don't know yet. Not at least the literature that I've reviewed has those answers, but to say the least. And it is it's a bit difficult to understand. 

Nanci: I am really grateful that you, am I cutting you off, Debbie if you want to jump in because I can come back. I don't know. 

Debbie: no go ahead. 

Nanci: I had I'm so grateful that you brought this up Andy because I have to say that even though I haven't read a lot in this literature it’s a topic of interest of mine and I've done some of my own advocacy and fundraising years ago, actually, with Debbie As my mentor, but in the paper, I paused, as you were getting into talking about the, sort of this bilateral, contribution to abusive emotional abuse. And I paused. and I was like, wow, okay, and I just sort of let it sink in. I’m like, okay. Well, I'll go back and get in and read it and, and, and I can't close my eyes to it. I try to understand it. And also, what you also mentioned a minute ago is when someone is not just a victim, but perpetrates some emotional abuse to their partner, that that has some paradoxical consequences and I just, you know, I'm like that's so fascinating. What, I don't know what to do with it. Usually, a study of the findings to me, seems like there's a clear message will like what will we tell people? What can they do? And these findings are really hard for me to know. You know, what can we do with it? Like what does what is the message? We want to get, you know, take from the findings that are we can't ignore. Does that make sense? I don't know if it does. Any thoughts about that some of this complex, maybe not the first wave of thought about domestic violence, but definitely important relevant findings.

Andy: Yea, I think the complexity is one of the first important findings are acknowledging that abuse looks different across settings and different relationships and acknowledging that these different behaviors and whether it’s physical abuse or emotional abuse, all are nuances that are important to consider, when thinking about, I guess risk for that. As a clinician, I do a lot of couples therapy and when your watch working with clients, you are making evaluations on the risks of certain behaviors. And so, I do thinks there are a lot of nuances to take into account, and we can talk about like, the specific findings that are relevant for each specific one, but essentially, in this paper, we did want to look into the nuances about whether the associations between emotional abuse and PTSD symptom severity varied between you know, unidirectional violence, which is what most people think of where there's a single perpetrators singular victim and this bi-directional violence which, you know, is a little less talked about but understanding how that might vary and more importantly, whether it doesn't vary is also very important, but specifically I guess the most important non-finding I think Is that the effects didn't vary for restrictive engulfment and physical abuse, so it doesn't matter if you are also engaging in some kind of level of aggression back, it doesn't matter if you aren’t these effects being consistent across those, those dynamics, which I think is important takeaway and it's, you know, not get caught up in the complexities that restrictive engulfment, isolating behavior and the physical were consistent across everybody, really? We didn’t really start to get into more nuance until we started looking at some of the other papers like denigration and hostile withdraw which do have some more nuances to what that mean in regards to the association between emotion regulation, sorry, emotional abuse, and PTSD. 

Ryan: We can go into the James gross model, emotion regulation, stuff If you want. Well, it also just What Debbie was saying earlier to just around like, sort of the myth of like, why don't people leave? And I was just wondering, and I have no evidence that y'all lab does this, but I just make me wonder if you have any if any of the studies sort of measure like, for have any follow-ups in terms of if people stay in those relationships and I totally understand why, like the longitudinal piece is really difficult, but even just like the piece of like do people, did these couples stay together for like a year if I was just curious if any of y'all studies like if you end up going back to those, to see. 

Andy: Nothing comes to my mind

 Ryan: and that’s totally fine, that’s totally ok, that's just interesting to me, too. Because it makes me just wonder sort of, sort of what do these people's relationships, like you’re saying like the dynamic sort of overtime, or really fascinating of, of just how these Dynamics could play out in different people's relationships, and if people do stay, and how long, if it's these different components of emotional abuse and just how long these pieces are coming, or people are experiencing these Components. 

Andy: the only link to that. Oh, go ahead Debbie. 

Debbie: Another question. While you were giving the answer to that one. I was curious about the demographics. Even of your study. How long couples have been together that sort of plays into what Ryan was asking about. And whether you found difference between different ethnic backgrounds or and whether you had any LGBTQ couples or how, I know you would have to have a really large sample to really investigate the differences between couples, but I was curious about also. 

Andy: Yeah, we do. Look at those possible control, covariates things to control for, and in this study and particular, none of those played a role. We always do like a preliminary analysis to see if we should control for differential levels of age or difference across race or socio-economic. We did look into that. And the symptoms of PTSD wasn’t related to any of those things. That's like the important thing is that, is it related the outcome variable. We can test if there's differential effects across those but like you’re saying it does require a larger sample size that we can have for this thing, but in regard to actual generalizability of these findings, is that our sample was, barely, it wasn't just a white temple, which is what you tend to see mostly. If anything. It was actually quite spread out as far as race and age and socioeconomic backgrounds. So yeah, I mean, they're there is more discussion about like what it means, if these effects differ across those like, you know, you're mentioning it because

Ryan: I guess I was just curious too because you were talking about that it's not as difficult to recruit as we might imagine, and I was just wondering what pieces in terms of just like self-selection of people who are opting into these kinds of studies, if there are pieces that you just sort of think of because I know we like my lab does bereavement research and there are very clear characteristics of people who can take the time to do like, our four or seven hour long visits in the middle of the day, kind of a thing  when they've just lost their spouse, who might have been making they’re income. And so, I'm just wondering if in y’all’s line of research if there are sort of different self-selection pieces that you sort of think of across the studies, or if you are sort of feeling like, you are able to get more of a representative sample for this kind of research

Andy: you know, that’s kind of tough to stay in this current world because we actually have not done a study and really long time. You know, there's this question of, like should we use gift cards over cash. Because cash used to be the biggest thing. But there’s certain ethical things to consider with cash and gift cards. And I guess I don't really have a good answer that we got one because of course, it has been a long-time since, we’re about to start a new study. So, I guess I could speak to that a little bit more soon, but it is something that absolutely does need to be considered because it is a long time to come in is assessments last for four hours and studied sometimes, we break them up into two assessments. So, it does have some selection bias and that’s most likely because, you know, not everybody can do that. Really. 

Nanci: Do you want to take a minute and tell us what the upcoming study is about a little?

Andy: Sure. 

Ryan: We're all excited about future actions. 

Andy: So, Dr. Babcock currently is looking at what, well let me take a step back. We have couples come in and they have them engage in a conflict discussion. We find something that they both disagree about is something that tends to get a little bit emotionally heated when they talk about it and we have them just talk about that conflict, while they're doing that we do have them hooked up to physiological equipment to see how their emotional, you know, specifically their autonomic nervous system is aspiring during that. And we were also videotaping them to get specific observed behavior that we can get that is coded later by research assistants. And then what we do or at least what's going to happen in this. Next study is we test to see if we can apply either an emotion regulation skill or some kind of communication skill to reduce the amount of aggression, that's observed, during the conflict. So, that's what this, and then we have them do the conflict again, to see the changes anything and then, we always, of course, have some kind of control group in there, who doesn't get any kind of experimental treatments skill. And to see if, you know if they stay the same, all the people, hopefully in the treatments or skill group, change their behaviors and such. So, if it does involve couples in which there’s been at least one active one or two acts of physical violence or, but we are also kind of widening it to psychological aggression and things like that. So, yeah, that's what's and we're doing this because a lot of the current treatments aren’t, they show pretty weak effect size in helping committed individuals, become less violent so, the idea is that we are trying to find specific skills that we can teach individuals to help them be less aggressive with their partners because the current ones are to give you an example, the effect size for the current treatments for violent men is like 0.1 is less than 0.2 to which the average treatment for psychological disorders is like 0.8, so, it's relative to other treatments the treatments for individuals would perpetrate inter-partner violence is not very good. So that's why we're doing these specific skill testing is to identify like specific things that we can actually change about the current treatment modalities. 

Nanci: That's fantastic. That’s really encouraging. 

Debbie: Yes. 

Nanci: You had said earlier something about how couples come in and they feel you know, good about coming in and I'm, I'm thinking back to when I had my early teacher training, you know, to teach little kids. They recorded video recorded us, which was like cutting edge at the time Anyway, then we got to see ourselves teach teaching and do some self-correction. And I don't, you know, obviously your studies already designed, but I wonder I wonder if that would be positive or negative helpful or not. I'm just throwing that out there because I can't help myself because I think, you know, sometimes I'm in situations. Like I just wish I wish I wish I could remember all those details, I wish I could remember how I reacted to something. So, I'm wondering if that it has a potential as a tool at some other point. This studies already designed, just throwing it out there. 

Andy: I mean, that's definitely been thrown out there and treatment modalities of kind of monitoring and coaching. It's definitely something that I think has probably been in research, whether it's been specifically with in partner violence I don't know what that that would be interesting. 

Nanci; Yeah, that makes that makes sense. It's come up. You know, I'm wondering if you know, we're hearing like a lot of about a lot of different studies and thinking back to the work that you're doing Debbie or your colleagues are doing as well, especially providing all these services for people in need and I know that you can't, once when, when individuals, as you said, primarily women are, you know, in their homes and they're not and they haven't left yet it you can't reach out very and directly to support them but once they come and ask for help can you see how the ways that these different dimensions that Andy’s been talking about and that we were reading about a little bit in the study can kind of can you see how maybe the work that's being done at My Sister's House has to sort of build people up again. So, they aren't so isolated that they don't feel so denigrated. I mean, is that part of the mission part of the work? Or how does that? How does that play out? 

Debbie: Definitely, without we refer to those, we refer to clinical therapy and case management as stabilization services. So, average tenure in the shelter, average time in the shelter is 30 to 60 days. And clearly, a woman who has been isolated prevented from working, not doesn't have car doesn’t have savings prevented from any participation in the family's resources, 30 to 60 days, passes pretty quickly. And so, the services that we provide are really just to have women, be able to reflect and breathe and feel safe. And just that feeling of safety is really important. And until then women feels safe she can't really an individual, we do shelter men as well. It's much more rare that a, that a male victim contacts us, but we have sheltered men and their children. So, to the stabilization services, it is required in the shelter that women participate in individual therapy, Group session and that their children parenting skills if they have children and that the children also participate in a children's program. So yes, we begin right away, and those services are what really provide the scaffolding to move on. And we are actively trying to raise funds. So that when the 30-to-60-day period is over, we can move women into or men into apartments and we believe and research confirms this, that when women are able to live independently a year later if we can sign a lease for a year and a victim can stay there for a year they are really on the road to permanent recovery. And the temptation to go back to an abuser is really significant, not just to be with him or her but because of stability and familiarity. And the children want to see the mom or the dad and the pet because we don't allow pets in the shelter and believe it or not a lot of victims are just really distraught over what is going to happen to the dog and he'll probably beat the dog now, so, yes, we do attempt to really saturate our victims with services to shore them up and allow them to find their own power and resiliency. 

Ryan: What incredible and incredibly important work and I'm just having such an emotional reaction to when you mentioned that the pet and the dog example to and that that's something. I'm just mentioning this because in our sort of work around bereavement and just the idea of like the people and potentially animals that you have built those relationships with that help, you relieve your own distress, it just strikes me as sort of another form of that isolation, sort of after if you've then lost that creature that was helping you cope with that circumstance that you were in. Right? So, at that point it's like if you have sort of placed that like relief of distress on to this animal and then you're not able to have access to that animal for very real reason. Everything else. I'm just thinking that that could feel again like a little bit of that isolation piece just sorts of carrying on with you. And I had never considered that in this context. And so, I just I just think the work you all are doing is so important and it makes me just wonder to sort of in this context of the kind of work that and he's doing and, in more couples, where it hasn't turned to the point where one has actively left. Is there anything that you're sort of wishing or that your organization may be is wishing that with studied more within these kinds of couples. Who maybe have violence going either one direction or both directions, and I'm just curious from your perspective where you're actually really seeing these couples or the aftermath of these couple’s sort of what you wish, we knew more in the lead up? 

Debbie: Our mission statement is to end the cycle of domestic violence. So, we really focus on education and teen violence. So, we're trying to just regress it a bit and we do a lot of work with schools. So, I I'm keenly interested and how to alleviate number one, how to alleviate the PTSD that children are experiencing and, and therefore break the cycle, because children, which witness any kind of abuse are much more likely to be perpetrators, or victims, in their adulthood. So, really children are a big Focus. I'd also really be interested in general societal corporate levels of awareness around partner, intimate partner violence. And so that kind of those things because I think education is really the answer to all of that. 

Ryan: That is such a good answer and what you just said, just sparked something in me again, because bereavement stuff. So, I think a lot about just what bereavement leave looks like. And I think that that's another piece what you're sort of saying of just sort of organizational and like structural awareness and Sort of availability for a woman or a person to build that support network backup, and them self-esteem and everything else. And I would imagine there is not that kind of support or like freedom or time off built into many organizations. So, a lot of the time you're choosing too either work through, while you are in and not choosing, but not having to needing to right who make an income to work through work at the same time that you're having to completely rebuild your whole life. And what, what, a So level of stress that is. So, I think we are point just there around sort of organizational support and understanding and just knowledge. I think that piece of Education both for children and all the way up is really important 

Debbie: Yes. Yes. 

Nanci: Absolutely, go ahead Andy. 

Andy: Yes, as you were talking too, I've actually run thoughts as well as like how do we just kind of increase awareness about it? Like I said earlier, like it's prevalent. It's within the communities. It's and you know, what’s the most digestible way to present that? to the community and to get conversations about it going is something that kind of kind of hit a wall with a lot of times because by no means do I want to like, ignore say that you know IPV is normal, but it is, it's common actually. It's not healthy, but it happens. How do you I hate to bring up that conversation without like an initial kind of knee-jerk reaction of like, oof, I don't want to talk about that. And I think possibly earlier on, I had that's when I was also interesting with this emotional abuse aspect of you know, maybe, if we just start talking about the names, we call each other, you know, like, you know, aspects of emotional abuse, which might be easier to talk about as opposed to intense acts of violence, that individuals might be less inclined to have an open conversation about I don't know. What do you think about making ads, conversations happen, more, I guess, increasing that awareness? Because that’s something I've been stuck on. 

Debbie: I think that's a really good idea. And I think that there would be avenues for such conversations. I think that I don't know what kind of an outreach, you might envision, but one thing that we've thought about is really meeting with church leaders because there are especially where I live people are affiliated with different congregations. And so, I think when pastors or clergy are known what to look for, they may become allies and even through their education programs. I think another this is much more ambitious, but another way to approach this would be and we're giving that some thought at our shelter is to not have a hidden shelter. We've thought for years that, and we've been an agency for over years here and our shelter is hidden. There's barbed wire around it, women and men don't come to the shelter. We house them separately, but women would be always escorted to the shelter by law enforcement. And so, some of the neighbors in that neighborhood, have an idea of what's happening there. But if the shelters were conspicuous and in the middle of a city for example, and they had the ability to keep clients safe while having walk-ins for information or for educational activities, workshops. If the doors were open, it could be more of a mainstream activity and service than the way it is. Right now. It's not a sexy topic, abuse, whether it's emotional or financial or physical and people shy away from it. So, I think you we need to move it into more of a mainstream position 

Nanci: that it is sort of blowing my mind because of the model how it's always been like that and it really speaks to this idea that even though we're talking about individuals or sort of like these isolated people, but they are you know, the nature of the problem make is I see, is partly isolation and yet, but they're not. And if we there it's so stigmatized and we so other like, you were saying earlier, the people who stay or who continue to be in these relationships? and doing things to make them less those people and more it’s our people. It's us, and that also speaks to what you were saying Andy before with the prevalence and the vulnerability that really almost anybody has if they don't have the skills and maybe the support to avoid these difficult, unsafe, behaviors, unhealthy behaviors.

Ryan: That was definitely, that was definitely one of my biggest takeaways from today was just, I really liked what Andy was saying and Debbie as well, just around sort of the need for education, but also, just that idea that it can be common but not normal and you can know that these things are not healthy, even if they are common. And I think that that is like it takes your second right to like to get that but what you're saying, and he is so important, right? Of like it is something that we need to talk about because it is so common. Even if we don't want to label it, as like a normal phenomenon because we don't want that to be seen as like condoning it that just that because it is common, we need to be talking about and I really like that distinction of common, but not normal. 

Nanci: Well, we've covered a lot of ground. We could go on, but we did promise to sort of wrap things up within a reasonable amount of time. And I know that I've learned a lot in this conversation, and I hope that each of you have as well. We, if there's anything else that you want to share before we go, that would be great. We just appreciate this so much and your time and your insights are really so significant. Thank you. 

Ryan: Yeah, thank you so much. 

Debbie: Thank you for hosting. I think it's really very obviously significant important topic and has societal implications and I'm really impressed with your work Andy and would love to stay in touch and see the results of the next study. 

Andy: Absolutely, thank you again for having me here. And it absolutely is a pleasure meeting you. Dr. Easterling and I have just so many ideas obviously after these conversations and I absolutely would love to keep in touch. And also, I think these sessions are extremely helpful, you know, we have these conversations about what this means about, like I said, it's happening in communities that we are living in right now, but I guess these avenues of getting this research out here as news is one of the most important things as far as disseminating this work. so, yeah, absolutely thanks for doing it. 

Nanci: Yes we promise to do that. I will try to be creative and really share this as widely as possible, especially to all these different avenues that you guys were recommending. So, we appreciate that. 

Ryan: Thank you for this occasion. 

Debbie: Thank you.