Nora Baladerian and Karyn Harvey are both psychologists with an unusual specialty — they are among a small number of therapists who treat people with intellectual disabilities who have been the victims of sexual violence.
They're friends, brought together by decades of shared experience. Baladerian, from Los Angeles, is a co-founder of the Disability and Abuse Project, which tracks violence against people with intellectual disabilities.
Harvey now works at The Arc Baltimore, a local chapter of the national advocacy group and service provider that assists people with intellectual disabilities.
A yearlong NPR investigation finds that people with intellectual disabilities suffer from some of the highest rates of sexual assault of any group. NPR obtained new numbers, from the U.S. Justice Department's unpublished data, and those show that people with intellectual disabilities are sexually assaulted at rates at least seven times the rate for people without disabilities.
On a recent trip to Washington, Baladerian and Harvey sat down with NPR investigative correspondent Joseph Shapiro to talk about the stunning levels of sexual violence they see in their clients' lives.
On how a person that a victim relies on, like a staff member, can sometimes be the predator
Karyn Harvey: Something that I've seen that happens in residential situations, I've seen a number of people where the staff have said, "I'm your boyfriend. And we're in a relationship. So, OK, so we're going to be boyfriend and girlfriend, so this is what we do every night." And so there was ongoing sexual abuse. And the most shattering piece ... finding out that that person was not their boyfriend. Because the woman is usually proud about it. "This is my boyfriend." And then we report. And then the devastation is that: "I was raped? That's not rape. That was my boyfriend. I was deceived. He said he loved me."
Nora Baladerian: The young woman was being taken by her taxi driver, paid by Medicaid, to take people to their medical appointments. ... So they were driving home and he turned right. And she said, "No, no, no, you're supposed to turn left." And he said, "Oh, we're taking a shortcut." You know, how many times have we heard that? So he took her into the forest, where he raped her. And then he started to go back to the car and she said, "Wait a minute I've got to get home. My mom's going to be really mad that I'm late."
On how even a family member can sometimes be a threat
Harvey: One guy, he was HIV-positive. We were working with him. ... And he had never revealed sexual abuse. And then his sister moved into his mother and stepfather's home, because she was getting divorced. And she brought her two young children.
And so he went to his therapist and said, "I have something to tell you. I'm very worried about my niece and nephew, because of what my stepfather did to me all those years and I don't want him to do it to them."
And so he revealed it. We supported him. ... We went to court. The man got a sentence. It was a very mild sentence, but he did go to jail, the stepfather.
And I was standing with [the client]. And his mother came up to him and said, "You just ruined our lives. I will never speak with you again." And she stopped talking to him. And he lost his family.
On how people can miss the ways victims with intellectual disabilities sometimes express distress
Harvey: It may come out as property destruction. It may come out as aggression. Whatever it is, this person is doing it out of fear, they've been triggered. They're having a trauma response. Their amygdala is flashing: "You're in danger. You have to do something."
Baladerian: They get flashbacks, like Vietnam vets.
Harvey: Exactly, the same that we see with many Iraq vets. Everyone says, "They're doing it for attention." The pattern that I've seen with people who've been repeatedly sexually abused is they develop these symptoms. They get put on psychotropic medication. They're looked at as somebody who just needs more and more medication. The medications interact. They create all kinds of problems.
On how bias against people with intellectual disabilities can be a barrier to getting help
Baladerian: For people with [intellectual] disabilities, who speak perhaps more slowly, or use a vocabulary that's not equal to their age or their expected educational level, they're seen as dumb, worthless, less than. And there's just a bias that they're not worth it, or they must have been complicit. More than anything, they're not worth the effort.
Harvey: I've been a psychologist for 30 years in this field, and I was first told by the people who supervised me, "Oh, you can't do therapy with those people." ... They're actually more complex, not less complex. But the view was, "Well, they're so simple."
Baladerian: The bias against people with intellectual disabilities is unfathomable to me, but it is very common. They're not really seen as people with feelings and life experience. ... Police are not trained how to interact with and how to understand that folks with intellectual disabilities are people with lives and feelings and fun things that they do and accomplishments and hopes and dreams and sadnesses, the whole range of experiences of a person that doesn't have a disability.
DAVID GREENE, HOST:
Over the past week and a half, we've been airing an NPR investigation that shows people with intellectual disabilities are sexually assaulted at rates seven times that of everyone else. In our series, we have heard from experts and prosecutors, families and people with intellectual disabilities themselves. Today we bring you the voices of two therapists who treat them. First, just a warning here, their stories could be disturbing to some of you. Here's NPR's Joseph Shapiro.
JOSEPH SHAPIRO, BYLINE: Recently I sat down at a table with two women, both psychologists. They're good friends, in part because they share a rare specialty. They're among the very few therapists who counsel people with intellectual or developmental disabilities who've been victims of sexual violence. And what they were saying about the violence and their clients' lives was disturbing, really stunning.
KARYN HARVEY: Was abused by a van driver - raped, it was a rape. And he changed the route so she would be the last one.
SHAPIRO: That's Karyn Harvey, a therapist from Baltimore. She's sharing stories with Nora Baladerian, a therapist from Los Angeles.
NORA BALADERIAN: He was being sexually abused by his coach, and he was told that if he ever told anyone, he and his parents would be killed.
SHAPIRO: They see a lot of women and men with intellectual or developmental disabilities who've been the victims of sexual assault.
BALADERIAN: The young woman was being taken by her taxi driver, paid by Medicaid to take people to their medical appointments, people with developmental disabilities...
SHAPIRO: For people with intellectual disabilities across America, there's a hidden epidemic of sexual assault.
BALADERIAN: So they were driving home and he turned right and she said, no, no, no. You're supposed to turn left. And he said, we're taking a shortcut. You know? How many times have we heard that? So he took her into the forest where he raped her, and then he started to go back to the car and she said, wait a minute. I've got to get home. My mom's going to be really mad that I'm late.
SHAPIRO: People with intellectual disabilities can be easy to manipulate because they've been taught to be trusting. Here's Karyn Harvey.
HARVEY: Yeah. I've seen - something that I've seen that happens in residential situations, I've seen a number of people where the staff have said, I'm your boyfriend and we're in a relationship.
SHAPIRO: They need to rely upon other adults - the parents, teachers, staff who help them.
HARVEY: Say OK, well, we're going to be boyfriend and girlfriend so this is what we do every night. And so there was ongoing sexual abuse.
SHAPIRO: Women and men with intellectual disabilities do have romances, relationships. Sometimes they marry. They can have consensual sex. But Harvey's talking about how for predators they can be some of the easiest prey.
HARVEY: And the most shattering piece - 'cause I've done the crisis counseling afterwards. This is five or six situations - finding out that that person was not their boyfriend. Because the woman is usually proud about it - this is my boyfriend. And then we report, and then the devastation is that, I was raped? That's not rape. That was my boyfriend. I was deceived. He said he loved me.
SHAPIRO: We found multiple recent cases where a victim can't talk at all. The abuse gets discovered only when the woman gets a sexually transmitted disease or pregnant.
HARVEY: And that's actually very common in institutions, pregnancy where you don't know what happened. I actually was called in on a case where somebody was pregnant during a long-term hospitalization.
SHAPIRO: Most rapes, of anyone, are committed by someone the victim knows. For women without disabilities, the rapist is a stranger 24 percent of the time, but less than 14 percent of the time for people with intellectual disabilities. That's what our analysis shows from numbers provided by the U.S. Department of Justice. Most of the time, the perpetrators are people they've learned to count on the most, sometimes their own family. Therapist Karyn Harvey had a client who was HIV positive but he never revealed how that happened, until one day.
HARVEY: And then his sister moved into his mother and stepfather's home because she was getting divorced, and she brought her two young children. And so he went to his therapist and said, I have something to tell you. I'm very worried about my niece and nephew because of what my stepfather did to me all those years, and I don't want him to do it to them.
SHAPIRO: Harvey and her staff encouraged the man and helped him report the abuse to police. The man was very close to his mother, but the case split the family, especially after the stepfather was charged, brought to trial and convicted of abuse.
HARVEY: This guy was sentenced. I was standing with him and his mother came up to him and said, you just ruined our lives. I will never speak with you again. And she stopped talking to him, and he lost his family. And I've seen this happen multiple times.
SHAPIRO: Prosecutions are rare. Convictions, even more rare, partly because people with intellectual disabilities often have difficulty testifying or they're easily confused on a witness stand, or they're just not believed. Nora Baladerian had a client who said she was sexually assault by men in the family. But at trial, the men were acquitted. The young woman had been the main witness, but her testimony didn't go over well with the jury.
BALADERIAN: The jury said, found him not guilty. When polled afterwards they said, why? And they said, she was too weird. Well, they just could not believe her because she was too weird.
SHAPIRO: Baladerian thinks flat out prejudice gets in the way throughout the criminal justice system.
BALADERIAN: For people with developmental disabilities who speak perhaps more slowly or use a vocabulary that's not equal to their age or expected educational level, they're seen as dumb, worthless, less than. And there is just a bias that they're not worth it or they must have been complicit. More than anything, they're not worth the effort.
SHAPIRO: There's one more thing that really troubles these two therapists, the trauma of all this sexual violence almost never gets treated. Sometimes a victim with an intellectual disability acts out. If they have difficulty using words, that's a way of communicating distress. Maybe they destroy property or they cut themselves or bang their head against the wall. Karyn Harvey.
HARVEY: Also, the other thing that goes unrecognized are their repeated suicide attempts because they're not shooting themselves or hanging themselves. They're running into traffic.
SHAPIRO: Harvey says she's seen five cases like that. What's most common is that the person is medicated on powerful anti-psychotic drugs.
HARVEY: They're looked at as somebody who just needs more and more medication, and the medications interact. They create all kinds of problems, and death occurs as a result of that, as well.
SHAPIRO: It's a spiral of bad outcomes, an unrecognized mental health crisis that's created from an unrecognized epidemic of sexual assault against people with intellectual disabilities. Joseph Shapiro, NPR News. Transcript provided by NPR, Copyright NPR.