By: Dr. Sharon Griffith, Director of Women’s Health Services

One of the factors that directly affects our mental health is a history of or ongoing individual trauma. Individual trauma results from “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”

May is Mental Health Awareness month, and is therefore a good time to learn more about how a history of trauma or ongoing trauma can affect all our mental wellbeing and that of many persons we serve in our health centers across CHN.

So, let’s talk about Intimate Partner Violence as a source of trauma. Intimate Partner Violence (IPV) is violence or aggression that occurs in a close relationship. The term IPV includes four main types of behaviors: physical violence; sexual violence; psychological aggression and stalking.

IPV is a pattern of assaultive and coercive behaviors that may include physical injury, psychological abuse, sexual assault, progressive isolation, stalking, deprivation, intimidation, and threats. This kind of violence can occur among heterosexual or same-sex couples and does not require intimacy. An “intimate partner” may be a current or former spouse, lover or dating partner.

IPV is very common. It affects millions of people in the US every year. Nearly 1 in every 4 adult women and 1 in 7 adult men report having experienced IPV. Imagine then, that in our CHN waiting rooms, one of every four women sitting there may have been a victim of IPV and one in every seven men there may have been a victim of IPV. Many of us might automatically think of IPV only as domestic abuse or violence, such as when an intimate partner is physically or verbally violent, or rape or sexual assault by a partner, spouse or date. But, as noted above, IPV can take many forms, so we must be vigilant and on the lookout for subtle signs or symptoms of IPV.

Let’s talk about physical violence. Physical violence is when a person hurts or tries to hurt a partner by hitting, kicking or using another type of physical force. Some pregnant women experience physical violence for the first time during pregnancy or an increased frequency of violent acts while pregnant. Some women experience physical violence after disclosing a new pregnancy to a partner.

Here are some facts: women with unwanted pregnancies are 4 times more likely to experience physical violence by a partner or husband than women with intended pregnancies. Women presenting for a third or subsequent abortion were more than 2.5 times as likely as those seeking a first abortion to report a history of physical abuse by a male partner or a history of sexual abuse. Some women may be struck in the abdomen or threatened with harm to their abdomen during pregnancy. Adolescent mothers who experience physical partner abuse within three months after delivery were nearly twice as likely to have a repeat pregnancy within 24 months.

At pregnancy testing visits, ask patients if they can make decisions about their pregnancy and birth control without any threats or fear from a partner. Who makes these decisions in your relationship? Would you feel afraid to tell your partner the results? Would you feel pressured to have an abortion if you didn’t want to? Would you be afraid of violence or harm if you told your partner you wanted to have an abortion?

At a pregnancy test visit you might ask- Are you feeling pressured to be pregnant? If the test is positive, would you be happy with the result? Would you be pressured to continue the pregnancy if you didn’t want to?

There is a high correlation between STI/HIV infections and abusive relationships.

Questions we can ask at STI screening visits, might be: Do you feel pressure from your partner to not wear a condom? Are you afraid to ask your partner to wear a condom? Does he ever get mad at you for asking? Are you afraid of how your partner may react to the news of the positive STI?

As healthcare providers we have an essential role in violence and psychological trauma prevention by discussing healthy, consensual, and safe relationships with all patients and screening patients where they are in our safe centers. We have resources available to all staff and patients at CHN who may be victims may be or at risk of IPV.

Our social work colleagues, health educators and mental health providers are a great resource for answers and support for victims of IPV and IPV induced trauma.

Feng shui (pronounced “fung shway”) is the ancient Chinese practice of arranging your personal space in a way that promotes positive energy. The idea is that the placement of objects in your personal space can affect your mood and motivation, foster creativity, and calm the flow of energy. Feng shui can also be applied to your workspace. You may not be able to change everything in your workspace to reflect feng shui guidelines, but try to follow as many as you can listed below:

1. Remove clutter. Organize unfinished projects or tasks in a folder, drawer, or cabinet. Store extra office supplies like pens and post-its in a drawer. Only keep things that you use every day out on your desk to help you focus on the task in front of you.
2. Stay organized. Organize things by date, color, label, or another way that works for you! You can even use this technique with your files, bookshelves, or food pantry at home. Do your best to put things back in their assigned place after each time you use them.
3. Position yourself with purpose. Sit up tall in your chair with your feet flat on the ground. Maintain good posture to exude confidence and create a positive space for you and others. Throughout the day, take small breaks from sitting to reduce stress and maintain focus.
4. Keep it personal. So often we can become overwhelmed at work. Keep things that make you happy on or near your work space. Add artwork and personal items. Display a picture of your loved ones or a picture of the beach. Make sure the images are uplifting. Bonus points for images that support your career path in some way. Adding a personal touch helps you feel like what you’re working on has purpose! Rotate your items from time to time to spice things up.
5. Simple is best. If you have nothing to put in a certain part of your desk, keep the space clear. Less clutter will help you concentrate and keep a clear mind.

Mindfulness is a tool that you can use to know about your thoughts, feelings, and surroundings. Practicing mindfulness can help you feel relaxed, creative, and focused. People talk about mindfulness and being more mindful, but what does it look like and how do you do it?

Mindfulness IS:

• • Being fully there and aware of what you are doing, thinking, and feeling.
  • Taking short pauses throughout your day when doing your daily motions. This will help you take a step back from what you are doing, to see the big picture and refocus.
  • Using all of your senses (hear, see, touch, smell, and taste) to enjoy and take in each moment.
  • Cleansing your mind and getting rid of the clutter.

Mindfulness is NOT:

• • Getting stressed or overwhelmed by what is going on around you or by things out of your control.
  • Letting your mind wander while you do a task (even while walking) or while listening to someone talk.
  • Clearing your mind or thinking of nothing.

Try these mindfulness exercises next time you:

• Go to a park. Close your eyes. Notice the sounds around you. Are there children playing? Can you hear wind rustling through the trees? Are there footsteps walking past you? What do you smell? Is the air warm or cold? Is the air dry or moist?
• Eat dinner. As you gather food on your fork, notice how much you are taking. Is your fork full, not full enough, or just right? Take a bite. Notice the taste of your food. Is it sweet? Is it salty? Is it full of flavor? What is the texture of your food? Creamy? Chewy? Crunchy? Notice how your jaw and mouth moves as you chew each bite.
• Crawl into bed. Turn the lights off. Take slow deep breaths and listen to your breathing. Notice the air in your room. Do a full body scan. How do your feet feel? Are they warm, cold, achy? Notice how your legs feel. Notice how your knees and hips feel. Notice how your back feels. Is it comfortable? Is it sore? How do your arms and hands feel? How do your covers feel? Are they smooth? Are they silky? How does your head feel on your pillow? When you feel your mind start to wander, listen to your breathing again.