Turning Points: Navigating Mental Health

Episode: Understanding and Overcoming PTSD in Women (S4E3)

Release Date: October 2, 2024
Host: Frances Lees (Tufts Health Plan | Boston Globe Media)
Featured Voices:

• Kate Speer (PTSD survivor and advocate)
• Dr. Tara Galovski (National Center for PTSD, VA)
• Sharon Imparato (Boston Area Rape Crisis Center)

Episode Overview

This powerful episode explores the realities of PTSD (Post-Traumatic Stress Disorder) in women, particularly stemming from sexual trauma. Through survivor testimony, expert interviews, and discussions about treatment and systemic challenges, the episode sheds light on both the psychological and systemic barriers facing survivors, while highlighting pathways to healing and the role of community support.

Key Discussion Points and Insights

1. Kate Speer’s Journey: Misdiagnosis, Trauma, and Reclaiming Agency

• Neurodivergence and Early Misdiagnosis

  • Kate discusses growing up with learning disabilities and undiagnosed ADHD.
  • Misdiagnosed with bipolar disorder due to family history, leading to a decade of incorrect treatments and worsening mental health.
  • “I was labeled as the wild child and the disruptor, but really I was just neurodivergent. Like on the scale. I'm all the way out there. Colorful, zesty. You got it.” (01:00 – Kate)

• Experience of Sexual Assault in Psychiatric Treatment

  • Assaulted by another patient in a residential facility; subsequent reporting led to disbelief and shaming by medical staff.
  • This compounded her trauma, triggering deep dissociation and PTSD symptoms.
  • “The doctors told me I was lying and I was, quote, crying rape. And this shattered me in ways that I still haven't fully processed.” (03:36 – Kate)

• Impact on Mental Health

  • Development of dissociative fugue states, psychosis, and shattered sense of self-identity.
  • “I think of PTSD often in terms of what it does to the identity as like a shattered mirror. But we take that mirror and it's scattered around.” (05:00 – Kate)

• Turning Point and Renewed Hope

  • Access to a renowned trauma specialist through her parents’ network. Faced a choice: continue institutionalization or commit to hard, independent work.
  • “He said, you've worked so hard already and I want you to know you have a choice because this work is going to be harder… And I said, no, I'm going to do the work because I know how to work. And the only thing that matters to me is that I have the right to be free.” (07:30 – Kate)

• Finding Agency and Healing

  • Emphasis on the importance of self-advocacy and resisting the “perfect patient” archetype.
  • “It's your life, it's not theirs. I didn't relearn that until this doctor reminded me of that.” (08:12 – Kate)

2. Therapeutic Approaches for PTSD

• Multi-Pronged Treatment

  • Kate details her use of exposure therapy (including narrative exposure and response prevention), somatic work, and Internal Family Systems (IFS) therapy.
  • “I really do believe that we can't do just cognitive therapy or just behavioral therapy or just somatic work. It needs to be a multi pronged approach.” (10:51 – Kate)

• The Role of Exposure Therapy

  • Gradually facing traumatic memories and physiological triggers safely helps to “marinate in discomfort” until anxiety diminishes.
  • Somatic work teaches her to “stay in my body, how to not live in a state of chronic fight or flight.”

3. Systemic and Societal Barriers for Survivors

• Institutional Barriers and Societal Blame

  • Sharon Imparato discusses how systems and institutions, not survivors, introduce barriers to healing.
  • “Survivors aren't the ones with the barriers, right? They face the barriers from institutions, systems, providers, society in general… I can't change what was done to them, but I can change how they understand what was done to them.” (13:41 – Sharon)

• Community Responsibility & Rape Culture

  • Perpetrators “groom communities” as well as victims, highlighting the need for broader community education and support.
  • “I think it's important to recognize that perpetrators don't just groom victims, they groom communities.” (14:52 – Sharon)

• Marginalization and the Hidden Epidemic

  • Disparities are even greater for women of color and trans people who are often not taught they can be victims, nor asked the right questions.
  • “There are many populations… not taught they can experience sexual violence. Women of color is one of those. Trans folks is another… Statistics are low—they're actually higher than we realize.” (16:58 – Sharon)

4. Understanding PTSD: Biological & Cognitive Impact

• Trauma’s Lasting Effects

  • Dr. Tara Galovski explains how untreated PTSD traps individuals in cycles of avoidance and physiological hyperarousal.
  • “When we keep avoiding every feeling, every emotion… we never let it [trauma] run its course… and people's worlds get smaller and smaller.” (19:40 – Dr. Galovski)

• Shattering Core Beliefs

  • Traumatic events act as “lightning bolts” that shatter basic assumptions of safety and order in the world.
  • Recovery involves rebuilding these models and returning traumatic memories to the past, rather than reliving them in the present.

5. Evidence-Based Treatments and Hope for Recovery

• Leading Therapies

  • Cognitive Behavioral Therapy (CBT) underpins the most evidence-based PTSD treatments: Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT); EMDR offers support with more mixed results for sexual trauma.
  • “PE and CPT were both developed in that population… Sometimes the end game is getting a good night's sleep… enjoying a movie… regaining that [from PTSD]…” (21:55 – Dr. Galovski)

• Importance of Functional Recovery

  • Success is often measured in real-life improvements: sleeping well, enjoying daily life, experiencing spontaneous joy.

6. Community Resources and Overcoming Barriers

• B.A.R.C. Services

  • Boston Area Rape Crisis Center (BARC) offers free, confidential support (hotline, advocacy, counseling, legal & immigration services) for all survivors aged 12 and up, in English and Spanish.
  • “We provide services for all survivors of sexual violence and their loved ones… [including] individual to couples to family to group counseling…” (23:57 – Sharon)

• Call to Action for Accessibility

  • Sharon reframes the question: it’s not “why don’t survivors come forward?” but “what about our systems stops survivors from seeking help?”
  • “The biggest barrier… is survivors aren't even given the space to recognize what was done to them… So, before we even get to types of strategies, it’s to… give a space to believe, to listen without judgment.” (26:08 – Sharon)

7. Empowerment and Messages of Hope

• Self-Acknowledgment is Vital

  • Kate stresses celebrating every small victory in recovery.
  • “If I could give any advice, it's that every tiny step matters and is worthy of celebration, like a home run, because that's the foundation for your future resilience.” (28:15 – Kate)

• Belief in Oneself Amidst Gaslighting

  • “Believe yourself. Because the world gaslights us all day, every day. And what you lived through was hell and you're still here. And that's nothing short of incredible.” (29:36 – Kate)

Memorable Quotes & Moments

• [01:00] Kate: “I was labeled as the wild child and the disruptor, but really I was just neurodivergent...”
• [03:36] Kate: “When I came forward... the doctors told me I was lying and I was, ‘crying rape.’ And this shattered me in ways that I still haven't fully processed.”
• [05:00] Kate: “I think of PTSD often in terms of what it does to the identity as like a shattered mirror...”
• [07:30] Kate: “I have the right to be free.”
• [13:41] Sharon: “Survivors aren't the ones with the barriers, right?... I can change how they understand what was done to them.”
• [14:52] Sharon: “Perpetrators don’t just groom victims; they groom communities.”
• [19:40] Dr. Galovski: “When we keep avoiding... we never let it [trauma] run its course and we prevent ourselves from recovering...”
• [21:55] Dr. Galovski: “The end game is to put the past back where it should be... regaining that [joy]…”
• [26:08] Sharon: “The biggest barrier... is survivors aren't even given the space to recognize what was done to them... give a space to believe, to listen without judgment.”
• [28:15] Kate: “Every tiny step matters and is worthy of celebration...”
• [29:36] Kate: “Believe yourself. Because the world gaslights us... And what you lived through was hell and you're still here. And that's nothing short of incredible.”

Key Timestamps

• [00:30] – Introduction of Kate Speer
• [01:08] – Kate’s mental health misdiagnosis & family history
• [02:04] – Sexual assault during psychiatric treatment
• [03:34] – Institutional response and further trauma
• [05:37] – Suicidal crisis and medical dead-ends
• [07:01] – Access to trauma expert, pivotal choice in recovery
• [08:36] – Approaches to healing and exposure therapy
• [10:55] – Multi-disciplinary therapeutic approach
• [12:07] – Introduction of Dr. Galovski and Sharon Imparato
• [13:03] – Insights into working with trauma survivors
• [15:30] – Gender disparity in PTSD incidence
• [16:58] – Barriers for marginalized survivors
• [18:33] – Impact of untreated PTSD on body and mind
• [21:55] – Evidence-based therapy overview (CBT, PE, CPT, EMDR)
• [23:57] – B.A.R.C. support services
• [26:08] – Systemic responsibility for barriers to care
• [28:15] – Kate’s advice for survivors and closing messages

Final Takeaways

• Acknowledgment: Believing and listening to survivors is foundational.
• Complexity: PTSD’s effects are multi-layered, impacting both body and mind.
• Treatment: Tailored, multi-pronged therapies are vital for recovery.
• Barriers: Societal and institutional obstacles, not individual survivors, are the primary hurdle.
• Community: Accessible services and education are key to supporting survivors and ending stigma.

If you or someone you know needs support:
Boston Area Rape Crisis Center 24/7 hotline: 1-800-841-8371

For more resources: Visit globe.com/turningpoints