In her book Phoenix Zones: Where Strength Is Born and Resilience Lives, Dr. Hope Ferdowsian draws on her experience working as an internist and public health physician around the world with survivors of trauma, including sexual violence. In this guest post, she offers her opinion, informed by the work she draws on in her book, on the US Senate’s approach to the allegations against Judge Brett Kavanaugh.

The views and opinions expressed in this article are those of the author and do not necessarily reflect any official policies or positions of the University of Chicago Press.

Process Matters to Sexual Violence Survivors:

The Senate Should Pay Attention

Dr. Hope Ferdowsian

The US Senate leadership is inappropriately rushing to a vote in their attempt to confirm Judge Brett Kavanaugh, an alleged perpetrator of sexual assault, to a lifetime Supreme Court appointment. Immediately after learning of the alleged assault and the victim’s name, many members of Congress dug their heels in the sand, refusing to relent even after new allegations surfaced. Rather than launching an investigation, some members of the Senate have spent their time attempting to demean and bully Dr. Christine Blasey Ford, Mr. Kavanaugh’s accuser. The matter has become more and more partisan, but it should instead focus on the most appropriate process for evaluating allegations of sexual violence.

Although Dr. Blasey reportedly felt it was her civic duty to report the assault to her congressional representatives, she preferred for her name to be kept out of the public sphere. Her identity was eventually leaked to the media, and she subsequently spoke on the record to The Washington Post, which also reported on corroborating details of her allegations. Dr. Blasey and her family have been forced to leave their home after she  received death threats. No wonder she did not want to come forward. Most of us would not. But she has, and it is now up to the Senate to get the process right.

The Senate leadership is doing everything wrong, in stark contrast to what those of us in medicine call a trauma-informed approach. Trauma-informed care is an evidence-based approach that emphasizes the importance of respecting the autonomy and voices of survivors, as well as the complex interactions between trauma and various physical and mental health outcomes. This is an important matter for Dr. Blasey’s well-being and for other survivors and the future of the nation.

In my book Phoenix Zones: Where Strength Is Born and Resilience Lives, I shared stories of my observations as a physician working with trauma survivors, including many who experienced sexual violence. I began writing the book in an effort to understand how we can promote more empathy, resilience, and nonviolence among individuals and within society. Over my career, I have especially struggled to understand how we can help victims of violence heal and find their own strength and resilience.

To victims, restoration of a sense of autonomy—control over one’s life and body—is a central factor in determining their mental and physical well-being. Infringements on choice, such as sexual violence, cause neurobehavioral changes that often take the form of learned helplessness, post-traumatic stress disorder, depression, and other mental disorders. Further encroachments on choice, including bullying behavior by interrogators, can cause re-traumatization. Fortunately, the brain’s neuroplasticity also allows for healing. A sense of control, autonomy, and empowerment can foster resilience. The relationship between autonomy and well-being explains, in part, why survivors are not legally required to report sexual assault or proceed through the criminal justice system.

A sense of justice is similarly important to survivor health and well-being, although survivors are also often re-victimized by the justice system. Many survivors do not report assault because of the potential for injustice and re-traumatization. However, the research literature suggests that regardless of the justice system’s outcomes, the spirit of justice remains important to recovery. Upholding a sense of justice through a fair process legitimizes suffering and offers hope to survivors, including those who are witnesses to the process. It seems particularly paramount that the spirit of justice is upheld in the selection of a judge who will serve on the nation’s highest court.

A forensic investigation—which the Senate leadership apparently wishes to bypass—also relies heavily on process. Because of the nature of sexual assault, physical evidence is often difficult to obtain, even immediately after an attack. As a result, corroboration from witnesses and treatment teams become critical to sexual violence investigations. Clinicians who understand the effects of trauma on the mind are key, since the most common scars after sexual assault are invisible. For example, mental health professionals understand the influence of trauma on memory. Intense experiences such as sexual assault increase the likelihood that individuals form strong memories related to the most salient details of a violent attack, including details that may protect the survivor from future harm. However, due to the body’s stress response and its influence on the subcortical areas of the brain, memories of small, less consequential details may be impaired. These factors should be kept in mind as the Senate moves forward.

Whether an appropriate process is upheld by the Senate matters both to the dignified treatment of Dr. Blasey and to the millions of children and adults watching. Norms like justice and accountability become more or less ubiquitous within society depending on whether justice is promoted or disabled. Cultural norms ultimately influence reporting patterns and whether future violent behavior is tolerated. In other words, the kids—including potential victims and perpetrators—are watching, much like my adolescent cohorts and I observed the treatment of Professor Anita Hill during the hearings preceding the confirmation of Justice Clarence Thomas.