THE COMPASSIONATE SIDE
June 12, 2014
By Jim Marshall
The IAED emergency Medical Protocols are based on established scientific knowledge about medical conditions. Likewise, best practices relating to callers struggling with critical mental health crises must flow from reliable psychological knowledge. Relating effectively to callers reporting sexual assault will require the dispatcher to understand the nature of the victim’s distress and the predictable human reaction of the 9-1-1 professional.
The caller reporting sexual abuse and the dispatcher may each experience an unspoken internal struggle that can impede the success of the call: They will both often feel ambivalent about investing fully in the call.
The victim of sexual assault will often be “preloaded” to feel shame, self-blame, and fear of judgment and blame when reporting abuse to 9-1-1, police, and, later, in court. She may be ambivalent about staying on the call, fully disclosing information, pressing charges, and following through with legal action. And most crucial to the caller’s long-term well-being, she may fear seeking therapy for the same reason, particularly when conditioned by an “intimate terrorist’s” chronic coercive control. Two-thirds of victims of intimate terrorism (compared to situational couple violence) leave within an average of two ½years from onset of the abuse. But it can take years to resolve the trauma and reclaim sense of self and quality of life.
The dispatcher is also under enormous pressure. Highly distressing calls can activate an emotional boundary that can be conveyed through the dispatcher’s tone. She carries the weight of providing empathy in a horrific situation while, at the same time, protecting herself from expending too much of her emotional energy. Yes, this is an awful thing to happen to you, caller if true, but I can’t let myself be pulled into the pain of your drama.
The dispatcher cannot be expected to fully take on the feelings of the caller; that’s not her responsibility. However, the 9-1-1 professional must strive to respect the caller’s feelings and recognize and acknowledge her ambivalence.
What does the caller’s ambivalence look like? The survivor is torn by two competing thoughts that might be expressed this way:
A part of me says he must pay for what he did, and I need help so badly—I will do it (inform authorities and seek help). But another part of me is screaming, ‘This was so horrible!’ I just want it to go away, not feel the shame, or talk about it. This person may not even believe me and I’ll just end up feeling humiliated. Maybe I deserved this. He (the alleged perpetrator) is right. I’m not a good person. It was my fault ... maybe it wasn’t as bad I am making it.
Sexual assault survival strategies
Defaulting to such beliefs can actually feel safer to the victim since the abuse remains private and seemingly more within her control versus if made public.
And if she dwells on the perpetrator’s control over her, she feels more powerless and at greater risk of future assault. Blaming herself for the sexual assault gives her a sense of safety and control over her environment. Shifting the blame—although misdirected—is a self-preservation strategy called The Locus of Control Shift. This shift (which may be unconscious) leads to a second belief: If I mute my protest and remain compliant, the perpetrator is less apt to hurt me again.
This Locus of Control Shift can often tip the ambivalence scale in her behavior choice from fully cooperating to hanging up, or minimizing and contradicting herself in disclosures to the dispatcher, field responders, and to medical and legal professionals.
Without understanding this survival strategy, the dispatcher’s response may swing from empathy and emotional investment toward more annoyance and a detached, more sterile response style: I’ve heard this before. Why don’t you just leave the tormentor?
The caller, already struggling with poor self-worth, may pick up on this attitude change fueling even greater shame, anxiety, and reluctance to cooperate.
The best response in complex psychological situations like sexual assault is guided by awareness of this ambivalence and the Locus of Control Shift. This is a tall order since the emotional labor demanded in such work with the caller can take its toll. Telecommunicators must be equipped (and choose to use) resilience skills to reset after such calls and to sustain resilience throughout their careers. Emergency dispatch leaders can ensure optimal response to calls involving mental health crises by providing appropriate training.
Editorial Note: We use the pronoun “she” in this article while acknowledging that neither sexual assault nor dispatch is exclusive to women. γ
1Michael P. Johnson. A Typology of Domestic Violence: Intimate Terrorism, Violent Resistance, and Situational Couple Violence. University Press of New England: Lebanon, New Hampshire, 2008.
2Colin A. Ross. The Trauma Model: A Solution to the Problem of Comorbidity in Psychiatry. Manitoba Press, 2000.