Lunch and Learn with Dr. Berry

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A quick search for the term "Physician frustration" brings up a whole list of different websites trying to come the conclusion of why physicians seem more frustrated now more than ever. Unfortunately, in the community of physicians we tend not to tell the other colleagues our problems and when asked everyone seems to be doing great until these anonymous surveys come out to tell us different. On today's episode I discuss the some of the frustrations that I learned physicians were having over the past few weeks.

In this episode you will learn:

• • Four reasons why physicians are upset
  • Some of the biggest regrets physicians have
  • When I plan on retiring from traditional medicine
  • Why relying on your medicine career is a thing of the past.

Social Links

• • • Join the lunch and learn community - http://www.drpierresblog.com/joinlunchlearnpod
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One of my biggest pet peeves is the fact that the media throws every celebrity who enters inside a hospital on their final death bed with only "life support" keeping them around. Like clockwork once rapper Rick Ross was found unresponsive over the weekend the media went to work putting out headline after ridiculous headline so this week will learn about life support and what different varieties it could be.

Links

• • rick ross remains in the hospital

In this episode you will learn:

• • About rapper Rick Ross
  • How many patient's Dr. Berry has taken care of on life support
  • What it means to truly be on life support
  • An common procedure that also puts you on "life support" that we don't talk about

Social Links

• • • Join the lunch and learn community - http://www.drpierresblog.com/joinlunchlearnpod
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    • For More Episodes of the Lunch and Learn with Dr. Berry Podcasts http://www.drpierresblog.com/lunchlearnpodcast/

If you are looking to help the show out

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Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, Spotify It's the leading cause of death WORLDWIDE. Its will cost the US over 200 billion per year and that number is only going to go up. This month as we have our annual celebration of valentines day and the release of The Black Panther I wanted to make sure we end the note understanding just how important staying heart healthy is to everyone. On this week's podcast we have Dr. Mike Morris, a renowned board Certified Cardiologist and newest contributor to the Lunch and Learn community who is going to show us why we need to be heart healthy today and stress the importance of seeing a cardiologist before its too late.

Links

• • Official Website http://www.drmikemorrismd.com
  • Dr. Mike's Best Selling Book http://www.drpierresblog.com/DrMike
  • Dr. Mike's Practice - http://www.atlantavanguard.com
  • Social Media Handle- @DrMikeMorrisMD
  • Head Strong Heart Smart Private Group - http://www.hshsgroup.com

In this episode you will learn:

• • Why it's important to go to the cardiologist
  • What is heart disease
  • What it means to be heart healthy
  • The Importance of American Heart Month
  • Best way to avoid becoming a broken down car (prevention options)

Social Links

• • • Join the lunch and learn community - http://www.drpierresblog.com/joinlunchlearnpod
    • Follow the podcast on Facebook - http://www.facebook.com/lunchlearnpod
    • Follow the podcast on twitter - http://www.twitter.com/lunchlearnpod - use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast
    • For More Episodes of the Lunch and Learn with Dr. Berry Podcasts http://www.drpierresblog.com/lunchlearnpodcast/

If you are looking to help the show out

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Being uninformed is no longer an excuse in 2018. Sexual assault is front and center on our television sets, newspapers and right in front of our faces. We have prominent figures rightfully being taken down their pegs of fame because of these terrible acts. Women now march in huge numbers to get the point across that no longer will they settle for the status quo of keeping quiet while being taken advantage of. Last week we had Rhodena Mesadieu, a licensed clinical social worker help us establish the foundation of what is sexual assault and this week I have the pleasure of having Marline Francois-Madden, a licensed clinical social worker who is going to help up pick up some of the pieces left over from sexual trauma.

Marline is the owner of Hearts Empowerment Counseling Center and Founder of Far More Precious Inc. In this episode not only are we going to be discussing the importance of healing from sexual trauma, but we will also get into a discussion on sex trafficking, why she started the non profit organization Far More Precious and her work with the Haitian community.

Links

• Official Website http://www.marlinefrancois.com
• Non profit organization http://www.farmoreprecious.org
• Brunch and Bond - http://www.brunchandbond.com
• Practice website- http://www.heartsempowerment.com

In this episode you will learn:

• What are the effects of sexual trauma?
• What event caused her to be working with the population she does
• Get educated on what is sex trafficking & who are the culprits
• Why she started Far More Precious, Inc
• What is Brunch and Bond & why its so important
• How do we work on getting the Haitian community involved with mental health care

Social Links

• Join the lunch and learn community - http://www.drpierresblog.com/joinlunchlearnpod
• Follow the podcast on Facebook - http://www.facebook.com/lunchlearnpod
• Follow the podcast on twitter - http://www.twitter.com/lunchlearnpod - use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast
• For More Episodes of the Lunch and Learn with Dr. Berry Podcasts http://www.drpierresblog.com/lunchlearnpodcast/

If you are looking to help the show out

• Leave a review on Apple Podcast because your ratings and reviews are what is going to make this show so much better

Download the MP3 Audio file, listen to the episode however you like.

Transcript of the show -

http://www.drpierresblog.com/ep55notes

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

Dr. Berry: Welcome to another edition to the Lunch and Learn with Dr. Berry, this is episode 55. Like always, head over to get the show notes at lunchlearnpod.com or drpierresblog.com/llp055. Today we have another great one. If you were able to listen to last week's episode, we had Rhodena Mesadieu, a licensed clinical social worker who specialized in sexual assault & sexual trauma. We follow right along with the same lines. I told you guys this was a two part episode of discussion. We have Marline Francois, out of New Jersey and again, I'm not going to butcher her bio. I'll let her do her own from that standpoint, but she, not only has experience and expertise in sexual trauma but she has also worked with victims of sexual trafficking. She'll get into discussion of what sexual trafficking actually means and I'll tell you right now. My only experience with it was naïve and what I would see on TV and what I would see on SVU.

Dr. Berry: So, she really breaks it down for us. And, we'll also talk about her organization Far More Precious, where she works primarily, with teenage at risk women. As well as, how mental health in the Haitian community is being affected during this time. So, sit back listen to another amazing episode with Marline Francois.

Dr. Berry: Alright ladies and gentlemen. First of all, thank you for joining another episode of the Lunch and Learn with Dr. Berry and I'm excited. We have an amazing guest today, Marline Francois and I'm not even going to butcher her bio. She's got a bio a mile long of amazing things that she's doing. Today, is going to be another special episode. We're going to be getting into some deep discussion, deep conversation that I think needs to be had. Of course, like you guys know whenever I want to listen and learn about a topic, that I may not be the foremost expert on. Again, I was obviously, as being an internist, I know a lot about a lot. I also know where my boundary lies. This is one of these topics where the boundary hits a full stop. So, I wanted to bring on an expert here on the Lunch and Learn and again, I just want to kind of give you guys a warm welcome to Marline Francois. Marline, thank you for joining the podcast today.

Marline Francois: Thank you for having me today.

Dr. Berry: So Marline, can you give a little quick bio of the Lunch and Learn community. Kind of let them know who you are, what you've been doing, and why you're doing such an amazing job at what you're doing.

Marline Francois: Yes, no problem. So, I am Marline Francois-Madden. I'm a licensed clinical social worker in New Jersey. I also do speaking engagements in the community, local churches. I've spoken at the Congressional Black Caucus for Women and Girls. I also run workshops for teens. I have a non-profit organization and I'm also the owner of Hearts Empowerment Counseling Center which is a therapy practice for women and girls. So, that's just a little bit of what I do. I also have a therapist planner which is a product that I sell for therapists. The first ever planner that has a lot of mental health diagnoses in there. Also has psychotropic medications so a lot of things that set social workers and psychologists and mental health therapists utilize. So, I incorporated all that into a product for them. So, that's a little bit of what I do.

Dr. Berry: All right, ladies and gentleman. I told you I was not playing. Marline is doing absolutely amazing things. We're going to get into everything. We're going to get into her nonprofit. We're going to get into the therapist planner which my wife is a loyal and happy customer of. So, again, we'll make sure we're going to deep dive in. Again, if you're not around where you can kind of write some of these things down, remember I will be putting all of her information in the show notes. So, you'll be able to get the therapist planner. You'll be able to get in touch with her nonprofit organization. If you're in the area, you'll be able to get in touch with her company as well. Like I said, this is a person doing absolutely amazing things. We're just excited to have her here to talk about a topic that again, unless you've been sleeping under a rock, has been kind of hitting you front and center.

Dr. Berry: The discussion of sexual abuse, sexual assault, and sexual trauma in general. Marline, can you kind of give us a little intro on, especially with your expertise and kind of where your focus is at as far as sexual trauma. How would you as a therapist define sexual trauma for the lay person who may not fully understand the subtle differences between a lot of the terms that they're starting to hear?

Marline Francois: Yeah. So, there's a lot of terms. You hear sexual trauma, you hear sexual abuse, sexual assault. So, for me the way I like to define it, so the sexual trauma, I believe that is what your symptoms that you're experiencing as a result of sexual abuse or assault. So, any of that could be related to rape, molestation, sexual harassment. Anything that involves with not having your consent. That can result to sexual trauma.

Dr. Berry: I think a big thing you talked about especially the consent aspect of it. I know being a male and being around social circles with a lot of males, I think the topic has came up in our groups. What is consent? It's two fold. Again, I like to play devil's advocate, but I think a lot of the men in the circles that I'm with or be with or just being around in earshot are at loss. For some reason, they don't understand what consent is anymore. They'll even say statements like, "What can I do now?" Can you kind of give a fresh breather on what consent means and why is it so important to actually have it?

Marline Francois: Yeah. So, for me, you need to hear the person physically verbally say yes or no. If you don't have that clear consent, it makes it a blurred line. I think if you've built a relationship with someone and you know that person, then it's one thing to understand clearly you're not going to ask your wife every single night like, "Hey babe, yes or no?" You kind of built that relationship with them, but if you don't really know the person, it is very important to have permission. If that person does not give you permission, then you're pretty much trying to take something from them without having that consent. So, it's so important. I think this is something even for young children and for young children, parents sometimes will teach kids that they own their body and for kids to understand what consent means and understand you own your body. You can tell people no.

Marline Francois: Because so often, even me as a Haitian person, growing up, when you walk in a room, you have to give everyone a kiss on the cheek. You have to say hi to people. You can't just wave. You have to go up to each person. So, you normally know. With little kids, sometimes there are people they don't want to be around, don't want to say hi. Now, you've kind of taken that right away from them and you're telling them, "You need to say hi to this person. You need to go up to them and give them a kiss on the cheek. You're being disrespectful by not giving them a kiss on the cheek." Now, that child, they no longer feel comfortable saying no. Then your girls become an adult. Then you don't know if you have that consent to say no. You just feel like, "You know what? I'm just going to do this because the other person want it. Even though I really don't want to deep down inside."

Marline Francois: Then you're left with the cognitive distortions and the shame and the guilt of the aftermath of what occurred. So, consent is such a huge thing. It's a matter of, "Okay, do I have this person's acceptance? Do I have an agreement with them to do this? Do I have their approval, whether it's through their verbal consent or their nonverbal cues that they're giving off?" Because sometimes people's nonverbal cues will tell you if they want to consent to doing something or not. So often people bypass those things.

Dr. Berry: Let me ask a question. What kind of drew you to the topic and the conversation and the field of sexual trauma and wanting to help especially women and young women in that circle? What drew you to that?

Marline Francois: Well, so since I was five years old I told my parents that I was going to be a clinical psychologist. So, at a very young age, I knew I was going into this field, but I think part of it also stemmed from the fact that I was a survivor of child sexual abuse at a young age, but I didn't disclose it to anyone until I was in college. So, at a young age, I would say my early teen years, I would read Teen Vogue magazine and there were other magazines like 17 and they would have these Q&A sections in a magazine where they would pose questions to mental health professionals and medical doctors and people would answer the questions. It was like a ask health section. So, there were always questions related to sexual abuse so I would always read those questions and read the response that the psychologist would reply back or the medical doctor would reply back.

Marline Francois: I was like, "Wow, this is so intriguing. I want to be that person who has a column in a magazine or helping young women to kind of find their healing journey." So, I think part of it stems from my own childhood pain and being able to grow up and fall in love with psychology because at a young age, I was really in to counseling and therapy. So, I just knew that I wanted to do some type of work that related to working with women and young girls that had a background of trauma.

Dr. Berry: Wow. Okay. First of all, thank you for sharing your story. Because I know a lot of times, that comes from a sense of strength of being able to experience something so traumatic and be able to kind of build on top of it. Now, you're kind of spreading that seed and helping others who are in positions that you may have been or your family or just people that we know kind of growing up. I'll be honest, just kind of like when I was doing my own research, I didn't realize how young sexual trauma and sexual assault and sexual abuse started. I think now we're seeing ... When we see all the stuff that's happening on TV and in Hollywood and almost now every industry which, again, isn't surprising. If it's happened in Hollywood, it's probably happening right down the road. So, we shouldn't be surprised that it happens in all these industries.

Marline Francois: Yeah.

Dr. Berry: But I think I was surprised and taken back of how early it starts. Could you explain just the mental toll that especially some of your clients and your patients experience and they have to go through when they experience it at such an early age but still have to kind of continue and grow and build and become their own.

Marline Francois: Yeah. So, it can start at a very young age because especially for children, they're very vulnerable. They're very vulnerable and you may trust a person, so about at least 90% of the time, you know who the abuser is. The perpetrator. Most people know who it is. It's either a family, a close friend, it's someone who has direct access to that person because what they do is half the time is they go through some sort of grooming process where they will think of sexual assault and sexual abuse. They automatically think that if somebody put a gun to your head like, "Hey, this is going to happen right now," but that's not the case in a lot of the assaults that occur. It sometimes it could be someone who's watching that child and they're playing games with them and they tell them don't tell anyone. Now the child is conflicted. What do I do?

Marline Francois: So, then they don't tell anyone. Then this person's like, "If you say something, then you won't have this. I will no longer give you these games or give you this." So, they're pretty much rewarding or bribing the child with something and now that child is conflicted and it can cause a lot of psychological affects afterwards. For some people, even some physical conditions. So, I've even worked with infants, babies that were under two that were raped I should say. It sounds really bad to say that. It's really hard to see a situation like that because then you could just think about the effects for that child and have the child having to go into surgery and the impact it it does on that child as they get older. They have to think about what happened to me?

Marline Francois: So, you just have to treat each case separately. Even as far as women who were in college, one in five women will be assaulted while they're in college. That's 20%. So, I think that's why a lot of colleges are also now starting they have sexual assault programs in school for college students so that way they can bring their awareness and free that safe space for you to go and approach people about what has happened to you.

Dr. Berry: That's really sad that even it starts as young as an infant from the lack of protection. In your practice, you see this trauma and you see the mental anguish. How do you as a health professional, how are you ... Patients will ask me that sometimes. They'll say, "Well, Dr. Pierre, how are you able to see from point A to point Z? Whether it be good times, whether it be bad times? Then you're just able to go home." "Clock out." Especially as a therapist. I'm always very intrigued with the therapist community because I'll be honest, as a physician, we may spend 15, 20 minutes. A lot of times we're kind of shooting the breeze. Maybe we're more directly asking questions and not really listening to answers in that point, but when you have the field of therapy where you guys are doing a lot more in depth talking, in depth discussion, how are you able to then move on or then clock out or then go home without that continually having to drag you on?

Marline Francois: Lots of self care. So, one of the things early on in my professional career, after I graduated with my undergraduate degree in psychology, I was working for Child Protective Services in the state of Pennsylvania where I resided at the time. So, the unit that I worked for was the adolescent crisis unit and it was children and adolescents. I had to be in their home three or four times a week. Very high crisis cases. Sex offenders. We'd go to sex offenders facilities. A lot of sexual assault and physical abuse cases. So, I remember in those moments when I was working late night and they're getting phone calls about someone running away or someone was just raped or we just went to the house and you couldn't believe it was this person who assaulted the child.

Marline Francois: I remember the burden that I had. I would go home and you would cry because you're pulling kids out of their home to put them in foster care. You're separating families. I remember the burden that I had and I was just like, "This is not healthy for me because if I continue to be this way," and I like to call that emotion compassion fatigue is what I like to call that. It's somewhat out of a burnout because you care so much and then eventually you burn out. So, when you get to that point, you can no longer really serve them effectively. So, in that moment, I had to realize I have to have clear boundaries. I need to set self care for myself and realize once I leave work, I am at home.

Marline Francois: It doesn't make me less passionate about what I do in any way because what I know when I go home, I need to have the self care to kind of rejuvenate myself and refuel myself and have time to do more research so I can learn, "Okay, what are some new methods that are out there? New interventions that I need to learn?" I think it's really important to have a great support system. I always recommend that therapists go see therapists or have therapists as friends.

Dr. Berry: Oh yes.

Marline Francois: Yeah. I have a large network of therapist friends and they have been very helpful when I needed that place to vent and just talk about things. My husband has been very helpful too. I think it's very important to have a support system that you can go to that will listen because so often, I find that when you go to people and talk about things, people are like, "Oh me too. I'm going through that too," but no one's really listening to what you're going through. So, it's important to have that. I think it's important to establish self care. It's important to establish boundaries because if not, you're going to feel the effects of it. It's going to be very difficult to really engage with your client in therapy and offer them the support that they need and some therapists also to evade there's this thing called counter transference where the client is talking about a situation that they're going through and now you're having flashbacks of what you went through relating to what the client is going through.

Marline Francois: So, that's why it's so important for therapists to have some sort of clinical supervision group or peer support group that they can talk about these things so they can figure out what do I need to do so I'm in a good space to help this client or else the client is going to, the client is giving you a therapy session in the room.

Dr. Berry: Oh yes. Physicians that are listening to the lunch and learn, I want y'all to really take heed. Again, you see the therapists are doing it. They understand that if they need self love, they need self care, they go seek others. They go seek it. It's no reason to be trying to hold it all in and deal with the anguish and deal with the stress that our field kind of holds on. So, I'm definitely happy that you brought that up because again, I have a few physicians who listen to me so I want to make sure they're all open ears. Now, Marline I was looking at the bio. Again, one thing that was very interesting to me was your work with women in Haiti in regards to sex trafficking. Now, I'll be honest. Again, as an internist, I know what I know. I know what I don't know. When I think about sex trafficking, all I think about is SVU.

Dr. Berry: I don't really have that great of a grasp of just the topic itself. Can you kind of give us a little bit of intro on just what the topic or the field of sex trafficking is and then really delve in to how are you doing such amazing work in that field.

Marline Francois: Oh yeah. Absolutely. So, with sex trafficking, it's an illegal business where people make it seem like it's not. It's a multi-billion industry that is happening so-

Dr. Berry: Billion?

Marline Francois: Yes. It's just like how pornography is. So, it's pretty much coercion, recruiting, transportation of a person or a child for the purpose of sex. So, so often when people think of sex trafficking or even human trafficking, when people think of that topic, they think of, "Oh, this is happening in other countries. It's not happening here," but it's always happening right in our back yards and January happens to be human trafficking awareness month. What people don't realize, for instance, New Jersey, so I reside in New Jersey and I'm near a lot of major highways. For people that a lot of the pimps I should say. The pimps, the johns, whatever you want to call them. The people who are running these businesses that are illegal, they tend to like to be near major highways.

Marline Francois: So, that way they can transport the young child, girl, women, man. They can transport them across state lines. So, they don't stay in one place too long. So, in New Jersey, we're near major highways to get to Philadelphia, south Jersey, Atlantic City, BC. So, we're near a lot of major highways so it's easy for them to kind of just be stationed there and then move the girls from one place to the other. What people don't realize with human trafficking, it starts at the age of 12. The age of entry is 12. The younger they can get the better for them they feel like. Some of them will also brand their girls. They'll put tattoos on the girls so they'll mark their girls as their property so that way they can not leave. When they leave and try to go somewhere else, another pimp will be able to identify that she belongs to so and so.

Dr. Berry: Wow.

Marline Francois: A lot of times, with these girls, they're vulnerable. So, you hear either girls that are running away. They may come from a home where they're getting abused or neglect. Foster home. You hear things like that. You also hear girls who come from a somewhat of a stable household. They may come from a household where they go to a good school, they have their parents' support. You think they have everything that they need because sometimes we tend to stereotype groups and families and I think even sometimes even physicians you have someone in their office. Like, oh, okay. She's pretty healthy. Everything's good. You find out something else and you're like, "Oh. Okay. Now, let's discuss that."

Marline Francois: So, people tend to sometimes stereotype like, "Oh, well, she just don't wanna act right. That's why she's in the situation." Not realizing that the pimps are getting very smart. They're up to date with technology and what's happening out there. So, they're using social media. A lot of times, people think the pimp is this older man with a gold tooth with a hat with a little feather and the pimped out suit. The thing that I found growing up back in the day on TV, but no. It may be the young guy who's 19 years old. They're attractive. He's driving a BMW and then this girl's in high school. She's like, "Oh, he got a car. He can take care of me." Because that's what they do. They tell them I will take care of you. I will get you a modeling contract. I will buy you this. I will buy you that. So, they go through this whole grooming process and for some of the girls it may take months or a few weeks to do that grooming process.

Marline Francois: Eventually that girl falls in love with him and he's like, "Babe. I don't have money. I need you to do this for me." Now, this girl's like not sure what she wants to do. Then she decides to do it and it's like you need to bring me back $1000 tonight or I'm going to kill you. I'm going to go back and kill your little sister at home. I know where your family lives because they've built that relationship with them so they know so much about that girl and her family that they now are cohorts into this. When they are picked up by the police, which is the sad part, is that they end up in a juvenile detention center or if they're over 18, they may end up incarcerated for prostitution.

Marline Francois: So, I know some states have made the changes with labeling it as child sexual exploitation and then other states are still working on changing the terminology when it comes to sex trafficking and the labels that they put on these girls, but they're not getting treated with trauma informed therapy and that's what they need.

Dr. Berry: So, now I gotta ask. Wow. What drew you to that? Was there a certain client and then you just kind of went in that direction? Especially of course, being of Haitian descent. I think and I saw it as oh. Okay. I gotta ask about this because again, I think you hit it right on the money. When I think about sexual trafficking and human trafficking, I always think it's out the country. I don't think it's in Florida or in New Jersey or in New York or in California. I think that concept is kind of lost on the fact that it happens right in our backyard, right under our nose and we're not even sure. Maybe we see, especially I'm on social media a lot so I'm always seeing I feel like it's almost every one or two weeks now so and so is missing. I always wonder. Unfortunately my first question is, "Alright, did they get kidnapped?" But secondly, did that happen? Did they go in that direction and that's why we can't find them anymore?

Marline Francois: So, the reason I went into this, I used to work for a residential therapeutic foster care program. So, pretty much these were kids that were in a foster home but they were in a ... they were foster homes, but then there's something a step higher than that which is a therapeutic foster home where the kids were required to see a psychiatrist once a month and you're required to go to therapy sessions weekly. So, working in that environment and working with teenagers, a lot of them were running away. Some of them had boyfriends that were older than them. I did some trainings as far as on running groups related to human trafficking for teams. I think running the group is when I watching the videos about it and then learning so much from the girls about how they had friends in high school who were getting all this money and had this older boyfriend or trying to coerce them into getting into the same route and saying, "Hey, girl. Do you want to come to me with this party? You can make some money tonight just by doing this. It's only this one time."

Marline Francois: So, then they were just going after these other girls too that I worked with. So, I think that's what made me really dive into it because I really thought it was like, "Okay. This is just an international issue. It doesn't really happen in New Jersey," but then I realized it was happening and I was seeing more stories and articles being pulled up about it. Having other friends who were also passionate about it and doing the work I recognized, okay. This is a global issue. It's happening everywhere and it's not being talked about enough in the US. So, that's how I got involved in it.

Marline Francois: Then eventually, it kind of led me to Haiti via interaction on social media with another person who was I believe a occupational therapist in Haiti at the time working at an orphanage. She connected me with someone else who was living in Haiti who was opening up their own transitional housing program for girls that were involved in human trafficking in DR and Haiti and were called the Jacks for Health and it was located in Jacmel. So, I got involved with them and went out to Haiti and got to work closely with some of the girls that were in this program. So, they provided safe housing for them, education, food, they had so many different programs they had with the girls.

Marline Francois: Having health educators there, having dance, Zumba, going to church every week. So, the girls really got to just reclaim who they were as a woman and just learning how to heal and just realize like okay. I can own my body back despite what happened. Hearing a lot of their stories really traumatic. Because you're dealing with something very different in Haiti. You're dealing with there's an economic crisis in Haiti. We know that. We know how in Haiti it's really hard for so many people to survive. It was just like a lot of these women felt like they had no choice. It was like my kids need to eat. They need to go to school. I needed this money so this is all I can do in the moment. I didn't want to, but I had to do it.

Marline Francois: Or hearing how them being beaten and raped by different men. Just the stigma with knowing what to call that and not being able to label it as rape. They didn't know how to label it as rape or sexual abuse or saying I was abused by this man. It was just like, "Oh, I had this friend and he would give me money. We would do things." It was like, "Well, did you want to do those things?" No, not really but I had to. Then the more and more I talked about it, the more and more the tears will come down their face and the embarrassment, the shame. It was like this is not your fault. I don't want you to put the blame on yourself. You were forced into this. Someone tried to take advantage of you.

Marline Francois: So, I think a lot of times, they didn't know. I think there's still that stigma I think even in the African American and Caribbean cultures when it comes to sexual assault and trauma. Things of that sort. So, for these girls where they feel like, "Okay. My family needs to survive and I need to do this so I can have $25 to put my kids in school for the entire month." Where here, public school. You have public school. You can go to school for free. You can buy your kid some clothes, but over there, it's like you have to pay for education. If you don't pay for education, what's going to happen with your kids? Trying to have money for food just the bare minimum they needed. It felt like they had no more option.

Dr. Berry: So, it's a lot of it seems especially it seems to come from a sense of an origin of survival. Whereas and again, obviously we don't want to belittle anyone who may be obviously going through the same things here, but it seems like almost a level of connectedness. There's a lack of connection one way or the other and that's how they get connected to said pimp and that's how they get connected to said home and away from home in a way because there's that lack of it.

Marline Francois: Yep. Yeah. Absolutely. There's no safety. There's no safety. Your basic needs aren't being met so now you're looking for another option.

Dr. Berry: How has especially all this stuff that's kind of been stemming from the fact that now it's popular, right? Now it's popular to have this discussion on sexual assault and sexual abuse and sexual trauma and hopefully soon sexual trafficking. How has that kind of helped spur your field and the clients that you may see now versus maybe a few years ago?

Marline Francois: I think now, because you have the whole Me Too campaign happening, you're seeing a lot more dialogue and discussion when it relates to women just advocating for each other and stepping up and fighting for their rights. So, you're seeing a lot more of that discussion happening so I think that women are ... Not just women. And men. So, people are becoming a little bit more comfortable with sharing and disclosing their own trauma and things that has happened to them and people are becoming more willing to go and seek help and see a mental health therapist. I also think also too, as therapists, we're putting ourselves out there a little bit more with speaking up more about what does it look like? What does your first appointment seeing a therapist look like? What is anxiety? What is depression? How do I know if I'm sad? What is mental health versus mental illness?

Marline Francois: So, we're having those discussions and I think it's becoming a little bit more accepting. We'll see someone. Look at Jay Z. He's out there talking about therapy. He put it on his album. He had it on his album and so I think when people are seeing celebrities talking about therapy and having the Me Too hashtag and campaign happening and seeing people all across people talking about it, people are like, "Wow, you too?" So, I think that's what people need. When they can see that, "Okay. I am going through something that you also went through or we share the same pain," it makes it easy for people to feel comfortable to share what they're going through and be more vulnerable.

Dr. Berry: At the level especially from being open, because I know obviously you work with primarily women and young girls. Do you find the bar much higher for men to want to come out and who may have experienced sexual trauma sexual abuse growing up to even admit it? Even to say me too? Do you find that to be a very stark difference, especially with the movement that we have now that, I don't want to say primarily seems to be women centered, but of course, again, correct me if I'm wrong. I think a lot more women suffer from sexual assault and sexual trauma.

Marline Francois: Yep. Yeah. Women definitely suffer more from it. I think when it comes to men, there's still this stigma like that didn't happen or people laugh at them. There's still this laughing concept like, "Oh, a man can't get raped." People don't understand it. Men also to themselves if they're put in that position, they don't want to speak out about it because that dialogue is not happening so frequently as far as what does it look like for a man who does not consent to this? It also for the statistics, only one in nine girls will experience sexual abuse before they're 18 compared to 1 in 53 boys under the age of 18.

Dr. Berry: Wow.

Marline Francois: So, the rate is higher for women to experience sexual assault and abuse. For me, maybe I think there's also maybe too lack... it's under reported. It's under reported not just for men, but I also think that in the African American community, it's under reported as far as sexual assault when it comes to the data. For men, if it happens, who do they go to? Because then it's like, "What do I say?" I think the impact also too if they were sexually abused by a male or a female there's a different impact. Because I know recently there was a story of a teacher who got pregnant by one of her students. The family were excited. The family of the young boy was excited about this that our son is having a baby with this-

Dr. Berry: Oh. Tell it. Talk about it.

Marline Francois: Yeah.

Dr. Berry: Talk about it.

Marline Francois: I had to shut it off. I'm like, "I can't do this. I can not do this right now." Then but you always hear that dialogue. I remember growing up always hearing that dialogue when I was in high school. The boys like, "Oh yes. I can just bang that teacher." It was like something you want to do. I remember growing up watching Dawson's Creek on TV and the boy, he was in high school, forgot his name. He was sleeping with his teacher. It was an okay thing for them. It was the thing that they wanted to do. So, it's still that thing where if a situation like that did occur, you can just only imagine. So, if he's telling his guy friends in the locker room like, "Yeah. Me and so and so." It would be like, "Me and so and so had sex." It wouldn't even be like, "Man, so and so came at me and she raped me." Because if he says that, the other guy's like, "What? I wish she would rape me."

Dr. Berry: Exactly. Exactly.

Marline Francois: You would hear ... Yeah. So, then it's like at that point, it's like-

Dr. Berry: It's so slanted for men to want and accept something that's clearly sexual assault, that's clearly rape, it's clearly sexual trauma, but mentally they're like, "Oh, no no. I'm okay with it."

Marline Francois: Yeah.

Dr. Berry: Absolutely. Yeah.

Marline Francois: Yeah.

Dr. Berry: How can, especially as a physician and of course I always feel that our therapists are really the front line when it comes to mental health and getting our act together as a community, as a country together. But I think the numbers don't lie. A lot of your patients will come see their primary care first, right? Not necessarily for mental health issues, but for their blood pressure. For their cholesterol. For some random.. but they still have those same characteristics. What are some things that, especially me as a physician, should be really looking out for and really keying in on when we're thinking about a history of sexual trauma or the effects of sexual assault when they're young, that I should even incorporate tomorrow in my practice and in my history taking?

Marline Francois: I think it's important to ... Some warning signs I would say look out. So, with the medical profession I would say asking them questions as far as with depression. I think it's called a PQI or PHI scale. There's a questionnaire we can ask them where it can kind of assess for depression or suicidal thoughts. So, looking out for some of those normal things like how's your energy level, your appetite, any sleeping pattern changes. Ask them questions about if they had nightmares or any flashbacks because nightmares and flashbacks are associated to PTSD and trauma. If you're scoping out their body, checking their heart rate and their arms to get their vitals things like that, seeing if you see any unusual cuts or bruises on their body to see is this person being abused or some sort of domestic dispute happening or are they engaging in self harm behavior.

Marline Francois: STDs is another big one. If they have had a history of any STIs or STDs, asking them if they remember how they contracted it as far as their sex life. Ask them questions about that to see what's going on with that because sometimes you may have people where they will tell you that their sex life is no longer the same because of some experience that they had that they weren't comfortable with. Maybe even assessing for drug and alcohol behaviors. Asking them who they reside with, who do they live with. Do they feel safe? So, you always want to assess for safety. I think safety is one of the biggest things and making sure that they feel safe where they reside at. Where they work at, where they live, go to school. Do you feel safe here? Are they in an abusive relationship or not?

Marline Francois: So, look out for those things. If you're working with a adolescent or a child, how are your grades in school? How are things going? Looking for unusual behaviors and asking the parents too. Have you seen any difference? Any significant changes lately in your child? Are they spaced out all day? Do you have a child who is in school now and now they're dealing with enuresis? So, they're bedwetting all day or they're reverting back to that behavior so that's happening too. That's another sign of some sort of sexual abuse so asking about that. Assessing those things as much as possible when you have that child or adult that's in your practice and figuring out, "Okay. What is unusual that's happening? Do you feel safe?" Just seeing how they engage with you in that moment.

Dr. Berry: I think that's important because I would have patients come in for very vague complaints. As a physician, especially if you're not thinking in that mental health aspect first and asking more in depth serious questions, you're running tests, you're ordering, you're sending them to different specialists and I remember specific, I had a patient. She came in. It was probably three times in one month which is totally unusual. Three times in one month came and it was always for something vague. It was always for something that it just didn't make sense when she told the story. I remember just asking one day. I said, "Is everything okay at home?"

Dr. Berry: That was all I said. Is everything okay at home? She began bawling tears. She began bawling tears because clearly she was coming because she wanted to say something but she didn't know how to say it. All it took was me for to ask that one question and it was almost like the floodgates. She was able to open up and talk about some of the issues that she was facing at home in particular. This particular case was domestic violence and get to the point where she was able to open up because she couldn't do it at home. Her way to get out the house was to have a doctors appointment and to be "sick." So, I definitely agree with just ... It almost sounds bad, but I think some of our doctors, we're just not asking questions. We're just not doing enough of that.

Marline Francois: Yeah. Well, I think also too, I know there was a doctor. I think her name is Dr. Burke. She's a pediatrician out in California. She did a TedX talk on the affects of child abuse and she talked about how when she was in her training and residency working in the ER and children were coming in with various complaints, but no one was really asking the right questions. She realized a lot of what they're going through are because of their trauma. Not the sexual trauma, but other forms of trauma that kids may experience. So, if you witness your parents in a domestic dispute, if you've seen someone get shot. So, a lot of the other trauma that occurs and how that affects a child. So, she started doing a lot of research and study around that and just being able to ask questions related to that. So that way she can better provide service and recommendations and care for the patients that were coming in to see her.

Dr. Berry: So, I want to, because I obviously this is such a powerful episode, such a powerful topic, but I do want to end on a more lighter note. I want to kind of segue and kind of talk about your nonprofit, right? I'll say this and I'm on this enough, but I'm a little bias, right? As a founder of a nonprofit organization, I love when I see other young professionals be able to say, "You know what? Yes I'm doing okay, yes I'm doing great in my field, but I want to do more. I want to do more for those in need." So, can we talk just a little bit about Far More Precious, your organization. Your nonprofit or 501C-3 nonprofit organization. For those who listen, that means you can donate money and be a tax write off.

Marline Francois:Yeah.

Dr. Berry: Can we talk a little bit more about that? Because again, I'm excited. I absolutely love the program. I love the theme of it. I always get inspired when I see someone who's like oh ok you have a nonprofit too? okay. I like it.

Marline Francois: Yep. So a lot of it stems from when I was in graduate school. I knew I wanted to give back for girls. Underserved communities and for me, a lot of it had to do with in my profession and in internship experiences working with teenagers and realizing that they were limited on resources when it came to academic roles and professional development and not knowing what opportunities are out there for them. So, this was a way to kind of give back in the community by providing those resources for young girls that were in high school. Being able to provide some academic scholarship. So, it was a way to kind of get into the schools and kind of do a lot of talks about self esteem and social media etiquette and goal setting workshop.

Marline Francois: So, that was my way of kind of just doing that for girls. Then also this year, what we're doing is that we're doing a five city tour in New Jersey, Brooklyn, New York, Baltimore, Maryland, DC, and Philadelphia, Pennsylvania. We're doing a five city tour where we're going to target 40 girls per city and we're doing a brunch experience for the girls. So, millennials love to brunch. I love to brunch. I'm obsessed with brunch, but then it seems like for young girls ... Yeah. There's a lot of events. Women are doing a lot of women empowerment events. There are conferences. There's a lot that's happening for young professionals, but for a lot of these young girls, they have conferences and workshops that happen with their school where you go to this workshop and it's like, "Okay. This is good. I sit here and listen to you talk all day. This is great," but being able to have something where they have brunch and you can sit there and chop it up with some girls you don't know just to be like, "Sis, I got you."

Marline Francois: Just to have that engagement and just to be vulnerable. Just have that safe space where we can talk about badder things that happen. So, we can talk about the cyber bullying that's happening in their community. We can talk about the young girls that have been dying from suicide. We can talk about the young girl who some young boys thought that she had their marijuana so they had her strip on Facebook live. Stripped her completely. Took her wig off and called her all types of degrading names. Only to find out that she didn't have the marijuana on her and for her to leave there embarrassed. So, you can just imagine the public humiliation that goes with that.

Marline Francois: So, a lot of these girls are dealing with issues that is not being addressed in their school and some of them don't have the opportunity to leave and go to some sort of community agency that they can go to or have some after school enrichment program. They may not have access to a therapist or maybe they don't know how to go how to seek help. So, then being able to provide a safe space for young girls to come out and eat food because we love to eat. Then they can take selfies but then they can learn something. So, it's me along with another therapist who's located in Philadelphia. We're teaming up together because we love working with teens and we're just going to talk about these issues. So, whether it's self harm, suicide, depression, your self esteem and trying to figure out what do I want to do with my life? So, that's pretty much what we're doing this year with Far More Precious is having this teen tour.

Dr. Berry: Yeah. Lunch and Learn community, y'all see how she kind of humble bragging. Like, "Oh that's all we doing this year. Just a five city tour. Couple coming near you." A little brunch. You know I love it. Again, especially because I'm around a lot of millennials, I'm around a lot of entrepreneurs. I'm around a lot of minority folks really doing big things. So, my interests are always piqued when things like that are happening. So, please definitely Marline, reach out to me whenever it comes time for donation time so I can definitely I would love to put my hat in and sponsor or kind of do something to kind of help those girls out. Because I think it definitely starts young. It definitely starts where we need the most help. Like I said, not to say that our older folks don't need help right. Again, I love the fact that I can call myself older now. I'm at the age now where I can say, "Back in my day," and say it with confidence.

Dr. Berry: You dropped a Dawson's Creek reference and I'm pretty sure we're going to have some people who are going to be like, "Dawson's Creek? What is"-

Marline Francois: Dawson's Creek. I know! That's what I said too. I was like, "Oh my gosh. They probably don't know what I'm talking about. Dawson's Creek."

Dr. Berry: So, I absolutely love it. Again, please definitely reach out. Of course, I will definitely be putting her information in the show notes for her nonprofit organization. Remember, 501C-3, that means you can donate that money and it will be a tax write off. So, don't lose, Lunch and Learn community. Definitely please reach out. Especially if you're in that northeast area and you can help out in any which way with the financial support, body support, location. Whatever you can do. Please reach out to her and try to make the thing happen for the 40 girls in each of those cities. Hopefully next year she can make it 60 girls and 80 girls. Because that's the direction and trajectory it should go.

Marline Francois: Yeah absolutely.

Dr. Berry: Now, I would be remiss if I didn't have discussion, especially when we talk about mental health. Someone would not like me if they say, "How did you have a therapist of Haitian descent on your show and you did not talk about us Haitians when it comes to the mental health aspect of it?" First of all, I'll preface it with what I face, just in the medical aspect of it. In the medical field, my Haitian community, you know I love y'all. But I face a lot of having to combat a lot of stereotypes. Having to combat a lot of juices and teas and different remedies that may have worked or not worked growing up in place of modern medicine. So, I know if I'm facing that in the medical realm in my community, especially because you're working with the young women in Haiti. How has that been accepted as far as mental health in general would you say?

Marline Francois: It's a trying ... Still learning because I've spent seven years working in a psychiatric hospital. I've worked in two separate psychiatric hospitals in New Jersey and in both of the areas, we have a large Haitian community so we've had Haitians come into the hospital. Some of them were accepting of their diagnosis and understanding that that they have schizophrenia, major depressive disorder, but then there were others who were like, "No. I don't have that. I just need to go to church," but I think it's so hard. It's really hard. It's a matter of just really engaging the community because as a Haitian community, we always go to the church first. The church is usually our stomping ground for a lot of our issues.

Marline Francois:So, you having some issues with your kid, you call the church. You call them to do a prayer at your house. I remember when I was little, I was sick one day. I decided to run around in circles or something and I was dizzy and I was dizzy for two days. How about my dad decided to bring the preacher to the house to pray for me? Instead of taking me ... Mind you. We've always had health insurance. Always had really great health insurance from his job. He was like, "Oh, no. We're going to have the leaders come over and pray for her. She'll be fine." I was good the next day. I probably needed to rest. Who knows? I was playing around too much, but it's those things that's like, "Oh. Let's just pray for you or we have this remedy."

Marline Francois: Every Haitian grandma has some sort of special remedy. Some ginger, some slice of orange zest leaves hanging in her house. Some bay leaves-

Dr. Berry: I done drunk plenty of tea.

Marline Francois: Yes.

Dr. Berry: I done drank plenty of tea. I done had to bath in plenty of tea growing up.

Marline Francois: Yeah. The funny thing is that I have started to incorporate some of those into my lifestyle like leaves, but it's just how we tend to go after more holistic approaches with the teas and the herbs or going to the preacher when it comes to something that's happening. Also too, in the Haitian community, people sometimes think maybe this is voodoo that's happening, so then people are going to a voodoo priest. So, it's things like that that are happening. So, I think a lot of the dialogue when it comes to mental health is bringing it to the churches. So, bringing it to the churches and just talking about what does depression look like? What does anxiety look like? What does ADHD look like?

Marline Francois: Maybe your child needs to get tested. How does that testing process work and evaluation when it comes to the school? Who can advocate on your behalf? Do you need to go to a hospital and get assessed by a psychiatrist? Do you need to get screened and evaluated? What would that look like for you? What does it look like to be put on medication? So, being able to just have that dialogue with them to let them know what it entails and how if you have a mother who's grieving the loss of her child or someone who just gave birth and dealing with post partum depression, what can we do to support her in that moment? So, I think sometimes in the Caribbean culture, we have this hush hush mentality. What happens in my home stays in my home. No one needs to know what happened and that's really not as effective when you need help because then you're suffering in silence.

Marline Francois: So, I think they need to be more vulnerability and them being able to know the resources that are out there. In New Jersey, we have a lot of support services, but it's a matter of getting more ... We need more Haitian therapists who speak Creole that are private practice. I think we can get more of them to go into private practice, that would help to change the game a whole lot. Especially when I'm getting phone calls from people who are like, "I prefer to see someone who's Haitian because I'm more comfortable. You understand the culture." So, being able to have more people for the referral boards because everyone has their specialty. So, I think the more and more we have those dialogues and offering just basic education and training, I think it starts there.

Marline Francois: Having that and then knowing where they can go for resources that's going to really help them realize, "Okay. Well, you know what? It's okay if I go get help. It's okay." Having the pastor support that. I think also having churches have some sort of counseling support services. I know the church that I attend, we have a list of directory of Christian therapists or groups. We have a grief share for people that are dealing with someone in their family that has cancer. There's groups of people that are recovering from substance abuse. We have groups for women survivors of sexual abuse, so having those things within the church too also helps because then people are more comfortable.

Marline Francois: The Haitian community seems like they trust the church. So, having that in the church may be helpful too.

Dr. Berry: Oh yes. Tell it. Tell it. That's so true because I used to have a lot of patients who would come to see me just for the simple fact that I spoke Creole. They would leave their doctor for years, but they're like, "No, you speak Creole so I'm going to come to you." Because it does make them much more comfortable. I can only imagine. It's like pulling teeth for me to get them to talk about their blood pressure and their weight and their diabetes. So, I can only imagine and I definitely do not envy your position having to get someone to open up about depression. Get someone to open up about bipolar disorder. Get someone to open up about being anxious. Again, I tip my hat because I already know. I already know the battles you're having to face probably trying to do just that.

Dr. Berry: How can, obviously if they're in the northeast area, maybe you can do virtual, but how can someone reach out and get in contact with you and get in contact with your organization or get your amazing planner like I said. Shameless plug, my wife is a customer of the therapist planner. So, I definitely can attest to the fact that if you're a therapist and you know, you're not as organized as you want to be. Now, I didn't say that you ain't organized, but you're not as organized as you want to be, this is definitely something you need to get in to.

Marline Francois: Yes. Yes. So, the way they can connect with me is why website. My website is marlinefrancois.com. I have several sites. Far More Precious website is farmoreprecious.org. If you'd like to get plugged in as far as with the girls brunch that we're doing, we are looking for sponsors and volunteers. That website is brunchandbond.com. I also have a therapy practice located in Montclair, New Jersey and the website for that is heartsempowerment.com.

Dr. Berry: Lunch and learn community, I told you had an amazing guest here doing absolutely big things. You listened to the list of things that she's running off. Again, these are amazing people doing some great things in our community and I'm just thankful that we were able to get her on and share her story and also educate us on what it really means. Like I said, we got a lot of learning to do as a health professional, as a physician. I take an onus in trying to make sure I empower myself so I can kind of help empower you guys as well. So, next week stay tuned for another amazing episode. Marline, thank you again. Like I said, I can't say it enough for coming on to the show and really helping to empower and educate us today.

Marline Francois: Thank you. Thank you for having me.

Dr. Berry: Thank you for listening to another episode of the Lunch and Learn with Dr. Berry. Please head over to lunchlearnpod.com where you'll get the most recent episodes as well as today's show notes for your listening and viewing pleasure. Like always, depending on where you're listening this to, please subscribe to the podcast so you can get all the latest episodes sent directly to you. We are at all of your favorite podcast listening stations including Apple Podcasts, Google Play, SoundCloud, IHeartRadio, Spotify, and Stitcher Radio. Again, thank you for taking the time to listen and empower yourself to take control of your health and we'll see you next week.

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In medicine being able to accurately establish your diagnosis can be the difference between life or death. If I don't correctly diagnose my patient, then I eventually incorrectly give the wrong treatment and ultimately can cause harm which I may not have a second chance to correct. At a time where sexual assault has almost become an everyday topic I knew that it would be important for the Lunch and Learn community to understand what is sexual assault and why it is so important to know the difference. On today's episode we have Rhodena Mesadieu, a licensed clinical social worker and we discuss the importance of defining the term Sexual Assault. Rhodena a trauma specialist who works in facilitating survivors' healing journey from sexual abuse in adult women and young girls.

Links

• Rhodena's place of business - http://www.soulspringsflorida.com
• Rhodena's Twitter Page - http://www.twitter.com/rhodena_m
• Rhodena's on Facebook - https://www.facebook.com/SoulSpringCounseling/
• Rhodena's email - [email protected]

In this episode you will learn:

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

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Download the MP3 Audio file, listen to the episode however you like.

Transcript of the show - http://www.drpierresblog.com/54notes

M. Davis-Pierre: Thanks for listening to the Lunch and Learn with Dr. Berry, here to help educate, motivate, and put you on the right path to take control of your health through weekly discussions on topics in the medical field, public health arena, and in your community. And now your host, Dr. Berry. Dr. Berry: Hey it's Dr. Berry here, board certified internist, host of the Lunch and Learn, and today's episode is going to be a great one. We have Rhodena Mesadieu. She is a licensed clinical social worker. She's going to be talking to us about sexual assault, how to really define it and really get to the nitty gritty of how it affects everybody, male and female. I really want to stress the male part, because I think that sometimes gets lost in this discussion. Dr. Berry: Unless you've been under a rock, you know sexual assault and allegations and sexual abuse have been all over TV, radio, Twitter, Instagram, Facebook; wherever you consume your media, there has been some discussion one way or the other regarding sexual assault, so I wanted to bring on a special guest who's an expert in this discussion to help me along and help the Lunch and Learn community, so stay tuned for an amazing episode like always. If you want the show notes, head over to DrPierresBlog.com/LLP054 and in the show notes, I'm also having a link for a transcript. We're actually going to be providing a transcript for you guys for this episode, so get ready and get set for another amazing episode here with the Lunch and Learn with Dr. Berry. Dr. Berry: First of all, thank you for joining another episode of the Lunch and Learn with Dr. Berry. Like I alluded to earlier last week, we have a special guest for a special topic. Unless you've been sleeping under a rock and haven't read a magazine, haven't turned on your TV, this is a topic that's been going across the board. There's really not an industry that is being affected primarily from the topic of sexual assault, sexual trauma. Like you know, as an internist, I know a lot about a lot. But when I don't know something, I always like to bring the big guns. I always like to bring the expert on. Dr. Berry: Today, I have one of those experts in the building. Lunch and Learn community, first of all, I want you to give a nice round of applause wherever you're listening to this episode, to Rhodena Mesadieu. She is a licensed clinical social worker whose specialty is trauma-focused cognitive behavioral therapy. But again, I'm not even going to butcher her bio. Rhodena, please tell the audience, tell the people listening who you are and why I am in such awe of why you're on the episode this week.

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

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

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

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

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

Dr. Berry: Lunch and Learn community, I want to tell you again; you're going to be extremely very educated by this expert here. Again, I'm excited to have her on the show this week. Again, it's only been five, 10 minutes, and I'm already adjusting the mindset of what it even means to be sexually assaulted; to be sexually abused; sexually harassed. There were terms that even I as a physician just kind of lump together. If anyone in the field should be able to recognize the subtle differences, and sometimes really not so subtle differences, it should be those in the healthcare field. Dr. Berry: If those in the healthcare field like myself have trouble separating the terms, I can only imagine what our quote unquote "laymen" may be experiencing, especially when they turn on the TV and they see all the women and men coming out. Almost seems like droves and telling their story, just kind of getting filed under that one umbrella. I definitely don't want us to downplay the importance of the definition, because again, with definition comes power. If we define it like we're supposed to define it, it allows our mind to really embrace when a lot of ... Again, I don't want to ... I'm not sure if victim is the right term, and please correct me if I'm wrong, but a lot of the victims ... the people who come forward in their stories, it allows them to empower themselves as well.

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

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

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

Dr. Berry: And for those who maybe that are unfamiliar with fibromyalgia, from an internist's standpoint, fibromyalgia is one of those diagnosis that we consider a wastebasket diagnosis. Reason being is that you have your patients who come in with chronic, excruciating pain and you may do a million dollar workup and not really find a reason why they're in pain. You check for everything. Arthritis, infection. Everything under the sun to try to see why is this patient in front of me having so much pain? And I can tell you as an internist, I will ... and as a physician in general, we are not the best. Again, I think I'm very fortunate. In close proximity, I have a therapist who likes to talk. And she stresses that I should like to talk. Dr. Berry: But I'll be honest. As a physician, that's not our forte. We tend not to talk a lot about the stuff we can't see. So because we can't physically see on the blood test, because we can't physically see on an imaging, we say we don't know. And we're not the best at trying to get down to the bottom of maybe there's another reason why she's having this pain and discomfort. In medical school, sexual trauma, sexual abuse isn't one of the questions we tend to ask when we have pain. It just isn't.

1. Mesadieu: Right. Right.

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

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

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

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

Dr. Berry: Oh, wow.

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

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

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

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

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

Dr. Berry: Wow.

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

Dr. Berry: Wow. Wow, okay. All right, like I said, you know, I'm usually not stuttering or at a loss for words, but again, those are ... This is a very telling topic. When you hear facts and figures and you're just like, "Wow." It just takes you aback, because again, I think a lot of times, we think of this topic and we think, oh no, this is primarily women. Only primarily women are going to deal with this. And no, no, no. Clearly as day, there's probably a lot of men walking around now who's experienced some form of sexual abuse, trauma. And again, I hate that I'm just trying to gel the words, but I shouldn't. But they're experiencing some type of sexual assault that's occurred some time in their lifetime. Dr. Berry: Again, one out of six. That's a lot of people. And they're still manifesting that even as adults. Do you see that a lot where something occurred when they were 12, 13, 14, 15 and they suppress it, they buried it, but now they have certain mannerisms and traits in their adulthood that you can almost, especially in your field with your expertise, point back to? Like, no, see what happened to you when you were 12? That's why you're acting the way you are now.

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

Dr. Berry: Wow.

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

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

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

Dr. Berry: That is just too funny. Because yeah, right when you say that, it's like, I wonder if they do that to you guys, too. Because I know they do it to us. But I know that they usually never come out and directly say, "Hey, no, this is why I'm here." All right, so again, I love to be enlightened, ladies and gentlemen. Again, this has definitely been an amazing one. Dr. Berry: How, especially in your line of work, how has all of the events that's been happening, starting from Hollywood and trickling to almost every industry now, where you got people getting kicked off the Today Show. How has that affected your field? Are you seeing more of an influx, or is it a different ... Is there more people coming, or are they coming at it different ways? What would you say that you've noticed as a big difference of the fact that now we are actually talking about it because we're forcing it in the open?

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

Dr. Berry: I'm so glad-

1. Mesadieu: So that's-

Dr. Berry: Ooh, I love it. Ooh, I'm so glad you said the men need to check themselves. Because I'm privy to a lot of obviously male conversations, right? Because they feel much more freer to talk. And instead of saying, "You know what? I need to make sure that what I'm doing doesn't cross any line," and I think we can talk about what consent means. They're talking in the sense of, "Oh, I need to protect my job." Or, "I don't want women around me, because for some reason, I'm such an animal, I cannot control myself if there's a woman in the board room, and I cannot control myself if there's a woman in the office, so let me just get rid of them instead of trying to change myself." Dr. Berry: And again, and I'm speaking ... I speak as a contingent, being privy to conversations. I'm like, does that make any sense? Again, I have two daughters. I have a wife. I have a mom. I have cousins. I'd never want them to ever feel that, one, they can't go to work. One, they can't act as if they want to act for fear of, oh, I might get fired. Or they're not going to be able to act, quote unquote "normal" around me.

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

Dr. Berry: Talk to them.

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

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

1. Mesadieu: Right.

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

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

Dr. Berry: Amazing, amazing gems. And you know what? Again, the men who are listening, you know what? If you have a question, just ask. Right? A lot of times, they won't even ask. They're like, "How come I can't do ..." Did she say you could? I immediately will point to them, "What if someone ..." Let's say if they're heterosexual. "What if someone of the same sex did that to you? Would you have no problem with that?" And automatically, you get the, "Well, I don't want ... No, no, no." Dr. Berry: Well, if you can understand what it means to have an unwanted sexual advancement, unwanted sexual comment in your presence, unwanted display of power, because I think men use it a lot from a power standpoint, whether position in a job, position at work, position in school. I think they use it as power more than anything, and when we start saying, "Well, you know what? You can't actually talk like this around women in your office, or women in your school." Right? I think they take it as, "You're taking my power away and I don't want my power being taken away in this matter. What other way can I circle around it while still keeping my power?"

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

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

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

Dr. Berry: Yes.

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

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

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

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

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

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

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

Dr. Berry: I can tell you-

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

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

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

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

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

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

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

Dr. Berry: Hey, Dr. Berry here. You have just listened to another great episode of the Lunch and Learn with Dr. Berry. Hope you learned something from today's episode. Hope you learn from all of the episodes that you get a chance to listen to. Before you leave, if you not have already done so, go ahead and subscribe to the podcast. I am everywhere where you like listening to podcasts at, whether it be Apple Podcast, Google Play, SoundCloud, Stitcher Radio, iHeartRadio, wherever you like listening to podcasts, the Lunch and Learn with Dr. Berry is there. Dr. Berry: Also, go ahead and follow me on my social media outlets. I'm on Instagram. I'm on Facebook as well as Twitter. All at Lunch Learn pod, whether it be Twitter.com/LunchLearnPod, Facebook.com/LunchLearnPod, and Instagram.com/LunchLearnPod, where you can get any videos, any pictures I may post, any messages or writing. Please follow me on there, right after you go ahead and subscribe to the podcast, and right before you leave me a five star review on either Apple Podcast or Stitcher Radio, or wherever you can actually leave a review. I'm much appreciative of all you guys' support, and like I said earlier in the show, I will see you next week. Bye.

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It is normally exciting news to hear that a company such as Amazon is making a push into a new venture and in my case healthcare but unfortunately the news has brought on many more questions than answers and I believe shines a light on a problem that has been in our face but for the general public we didn't even know it. Amazon's move in this direction isn't a result of a company wanting to try something new for the fun of it but a company realizing that the current health system is no good. On today's episode we talk about how bad our health care system is, how physicians have tried to get in front of the problem and what mindset patients will need to shift towards to make it a better place for all.

Links

• World Access to Health Care
• Amazon, JP Morgan Chase & Berkshire team up

In this episode you will learn:

• What do Amazon,JP Morgan Chase & Berkshire have in common
• What does this mean for health care?
• Just how bad is our health care
• What are physicians doing to stay ahead
• Why patients will have to change their mindset to get better care

Social Links

• Join the lunch and learn community - www.drpierresblog.com/joinlunchlearnpod
• Follow the podcast on Facebook - www.facebook.com/lunchlearnpod
• Follow the podcast on twitter - @LunchLearnPod - use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast
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• Leave a review on Apple Podcast because your ratings and reviews are what is going to make this show so much better

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Every year around this time I know you all get bombard with the TV commercials, your local pharmacies and your physicians all pleading with you to get your annual flu shot. For some of you (Approximately 40%) you heed the calling and get the flu vaccine and go about your merry way. Unfortunately, for the majority of the population for a plethora or reasons you don't get your flu shot and the culmination is what we continue to experience on a yearly basis where you continue to have reports of worsening flu seasons then the year's past. Today on the show I discuss some of the most recent startling facts about the flu season & why 2018 maybe one of the worst we have experienced in quite some time.

Links

• Lunch and Learn Episode 8

In this episode you will learn:

• Flu Virus Facts
• How many people are dying weekly this year?
• Recent hospital patient who "only" had the flu
• Where you can get your flu shot

Social Links

• Join the lunch and learn community - www.drpierresblog.com/joinlunchlearnpod
• Follow the podcast on Facebook - www.facebook.com/lunchlearnpod
• Follow the podcast on twitter - @LunchLearnPod - use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast
• For More Episodes of the Lunch and Learn with Dr. Berry Podcasts

To share your thoughts:

• Leave a comment
• Share this show on Twitter, Facebook

If you are looking to help the show out

• Leave a review on Apple Podcast because your ratings and reviews are what is going to make this show so much better

Download the MP3 Audio file, listen to the episode however you like.