World Psychiatry. 2013 Jun;12(2):111-2. doi: 10.1002/wps.20027.
The past, present and future of psychiatric diagnosis.
Source
Department of Psychiatry, Duke University, Durham, NC, USA.
- PMID:
- 23737411
- [PubMed]
Monday, June 24, 2013
In Debate Over Military Sexual Assault, Men Are Overlooked Victims - NYT
In Debate Over Military Sexual Assault, Men Are Overlooked Victims
By JAMES DAO
Sexual assault has emerged as one of the defining issues for the military this year. Reports of assaults are up, as are questions about whether commanders have taken the problem seriously. Bills to toughen penalties and prosecution have been introduced in Congress.
But in a debate that has focused largely on women, this fact is often overlooked: the majority of service members who are sexually assaulted each year are men.
In its latest report on sexual assault, the Pentagon estimated that 26,000 service members experienced unwanted sexual contact in 2012, up from 19,000 in 2010. Of those cases, the Pentagon says, 53 percent involved attacks on men, mostly by other men.
“It’s easy for some people to single out women and say: ‘There’s a small percentage of the force having this problem,’ ” said First Lt. Adam Cohen, who said he was raped by a superior officer. “No one wants to admit this problem affects everyone. Both genders, of all ranks. It’s a cultural problem.”
Though women, who represent about 15 percent of the force, are significantly more likely to be sexually assaulted in the military than men, experts say assaults against men have been vastly underreported. For that reason, the majority of formal complaints of military sexual assault have been filed by women, even though the majority of victims are thought to be men.
“Men don’t acknowledge being victims of sexual assault,” said Dr. Carol O’Brien, the chief of post-traumatic stress disorder programs at the Bay Pines Veterans Affairs Health Care System in Florida, which has a residential treatment program for sexually abused veterans. “Men tend to feel a great deal of shame, embarrassment and fear that others will respond negatively.”
But in recent months, intense efforts on Capitol Hill to curb military sexual assault, and the release of a new documentary about male sexual assault victims in the military, “Justice Denied,” have brought new attention to male victims. Advocates say their plight shows that sexual assault has risen not because there are more women in the ranks but because sexual violence is often tolerated.
“I think telling the story about male victims is the key to changing the culture of the military,” said Anuradha K. Bhagwati, executive director of the Service Women’s Action Network, an advocacy group that has sharply criticized the Pentagon’s handling of sexual assault. “I think it places the onus on the institution when people realize it’s also men who are victims.”
The Department of Defense says it is developing plans to encourage more men to report the crime. “A focus of our prevention efforts over the next several months is specifically geared towards male survivors and will include why male survivors report at much lower rates than female survivors, and determining the unique support and assistance male survivors need,” Cynthia O. Smith, a department spokeswoman, said in a statement.
In interviews, nearly a dozen current and former service members who said they were sexually assaulted in the military described fearing that they would be punished, ignored or ridiculed if they reported the attacks. Most said that before 2011, when the ban on openly gay service members was repealed, they believed they would have been discharged if they admitted having sexual contact — even unwanted contact — with other men.
“Back in 1969, you didn’t dare say a word,” said Gregory Helle, an author who says he was raped in his barracks by another soldier in Vietnam. “They wouldn’t have believed me. Homophobia was big back then.”
Thomas F. Drapac says he was raped on three occasions by higher-ranking enlisted sailors in Norfolk in 1966. He said he had been drinking each time and feared that if he told prosecutors they would assume it was consensual sex. Parts of his story are corroborated in Department of Veterans Affairs records.
“If you made a complaint, then you are gay and you’re out and that’s it,” he said.
Mr. Drapac, 66, said that over the coming decades he kept the rapes to himself, combating recurring nightmares and doubts about his sexuality with alcohol and drugs. But he began seeing a Department of Veterans Affairs therapist several years ago, and decided to tell his story recently after seeing accounts of female sexual assault victims.
“The best thing going on right now is that the women’s issue is coming to the fore and you see some mention about male rapes,” he said.
Many sexual assaults on men in the military seem to be a form of violent hazing or bullying, said Roger Canaff, a former New York State prosecutor who helped train prosecutors on the subject of military sexual assault for the Pentagon. “The acts seemed less sexually motivated than humiliation or torture-motivated,” he said.
But such attacks can be deeply traumatizing, causing men to question their sexuality or view themselves as weak. Some said their own families seemed ashamed of them.
“Being a male victim is horrible,” said Theodore James Skovranek II, who said he was sexually hazed in the Army in 2003. Some people told him the attack, in which another soldier shoved his genitals in his face after they had been drinking with friends, was not a big deal. But it made him question his manhood.
“I walked around for a long time thinking: I don’t feel like a man,” said Mr. Skovranek, who left the Army in 2005. “But I don’t feel like a woman either. So there’s just this void.”
Rick Lawson said that while he was in the Army National Guard in Washington in 2003 and 2004, he was repeatedly sexually bullied by a group of soldiers, including a sergeant who rubbed his groin into Mr. Lawson’s buttocks and jumped into his bunk and pretended to cuddle with him. Later, during preparations for deployment to Iraq, one sergeant handcuffed him and put him in a headlock while another pretended to sodomize him, Mr. Lawson said.
Several months after his unit arrived in Iraq in 2004, Mr. Lawson decided to report the bullying. His assailants were punished with reduced rank, Army records show, but he had to finish his deployment while living near them on the same base.
After he returned to Washington, he received a diagnosis of post-traumatic stress disorder and was discharged from the Army in 2006. He struggled with depression and lost a job, then decided to start an advocacy group for veterans.
“A lot of people say this problem exists because we are allowing women into the military or because of the repeal of ‘don’t ask, don’t tell,’ ” he said, referring to the ban on openly gay service members. “But that is absurd. The people who perpetrated these crimes on me identify as heterosexual males.”
Although the vast majority of military sexual assaults are by men, a small number of men have reported being raped by women.
Richard H. Ruffert, 50, said his boss in an Army reserve unit in Texas forced him to have sex with her by threatening to give him poor reviews. He said the sex continued for about two months in the late 1990s, until he attempted suicide. He then told a commander and, after a lengthy investigation, his boss was transferred. But he believes that she was never punished.
He retired from the military in 2004 and spent several years struggling with nightmares, drug addiction and homelessness, which he blames on the sexual assault. Therapy and working with veterans have helped him, he said.
But he does not feel comfortable dating women anymore. “This has completely changed my life,” said Mr. Ruffert, who appears in the film “Justice Denied.”
Many experts believe that the repeal of “don’t ask, don’t tell” will cause many more men to report sexual assault. That was the case with Lieutenant Cohen, who says he was raped in 2007 by an Army officer he had met in graduate school. At the time, Lieutenant Cohen was preparing to join the Air Force.
After initially remaining silent about the episode, he filed a complaint with Air Force investigators in late 2011, after the ban was rescinded. But the investigation took a surprising turn: after Lieutenant Cohen returned from a five-month tour in Afghanistan, he learned that he had become the subject of the investigation and was no longer viewed as a victim.
The lieutenant, 29, now faces a court-martial trial on multiple charges, including conduct unbecoming an officer. Lieutenant Cohen’s special victims counsel, Maj. John Bellflower, said the Air Force investigators apparently used information provided voluntarily by the lieutenant in bringing the charges against him, a possible violation of his rights.
The military recently told Lieutenant Cohen that it was reopening the sexual assault case. In the meantime, he faces a trial in July that he views as punishment for filing a criminal complaint against a superior officer. The Air Force denies that.
“I think the attention to this issue is absolutely needed,” Lieutenant Cohen said. “But it’s a little bit late. We still have attacks, and we still have retaliation.”
Wednesday, June 19, 2013
Salem witchcraft and lessons for contemporary forensic psychiatry
J Am Acad Psychiatry Law. 2013;41(2):294-9.
Salem witchcraft and lessons for contemporary forensic psychiatry.
Source
Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106. susanhfmd@hotmail.com.
Abstract
In 1692 and 1693, in Salem, Massachusetts, more than 150 colonists were accused of witchcraft, resulting in 19 being hanged and one man being crushed to death. Contributions to these events included: historical, religious and cultural belief systems; social and community concerns; economic, gender, and political factors; and local family grievances. Child witnessing, certainty of physician diagnosis, use of special evidence in the absence of scholarly and legal scrutiny, and tautological reasoning were important factors, as well. For forensic psychiatry, the events at Salem in 1692 still hold contemporary implications. These events of three centuries ago call to mind more recent daycare sexual abuse scandals.
- PMID:
- 23771943
- [PubMed - in process]
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