As investigators work to piece together the last decade of the lives of three women held captive, one question many want to know is, was there ever a chance for Amanda Berry, Michele Knight and Amanda Dejesus to escape much earlier than they did?
Berry, 27, DeJesus, 23, and Knight, 32, are believed to have been held captive by three brothers in small, modest home only miles from their families, according to authorities. Berry ended the nightmare Monday when she escaped by breaking through a locked door with the help of a passing neighbor.
But if that was the first attempt to escape while being held captive, it would follow a common thread of other surviving kidnap victims who decided to stay put, remain silent for a long period of time and in some cases, have a personal relationship with the abductor.
"The common modus operandi of a kidnapper or kidnappers is to create an extraordinary amount of fear that they have a capacity either to kill the abductee or to kill their family," forensic psychiatrist Dr. Michael Welner said today on "Good Morning America."
"Very quickly after the abduction the captor will do a variety of things physically, sexually to dehumanize the victim and it's the dehumanization that's the beginning of the process where a person loses their identity," he said.
That's exactly what happened to Shawn Hornbeck, who was abducted when he was 11 years old as he rode his bike in a St. Louis suburb in October 2002. He was abducted by Michael Devlin 60 miles from home.
When Devlin tried to strangle the boy, Hornbeck promised to never escape or tell anyone the truth about his captor, who is currently serving multiple life sentences. Hornbeck remained in Devlin's custody until police found him in January 2007.
"He felt somewhat guilty that he never could get away. I just had to reassure him that everything he did was right," Hornbeck's parents Pam and Craig Akers said in a 2009 interview with ABC News.
Jaycee Dugard, who was held captive for 18 years by Phillip and Nancy Garrido, told ABC News' Diane Sawyer last year that her captor's grip was so strong, she never attempted to flee.
"The mind manipulation plus the physical abuse I suffered, there was no leaving," Dugard said.
Dugard said that even when the doors were unlocked, she never tried to run.
"Something always held me back," she said. "It was like I had still had those handcuffs on."
While in captivity Dugard gave birth to two daughters fathered by her abductor. Dugard, now 32, said she felt guilty for bonding with Garrido.
In the case of the three Cleveland women, one of them, Amanda Berry, also gave birth in the years she was held captive. Police believe one of the three men arrested for the women's abduction is likely the father of Berry's 6-year-old girl daughter, Jocelyn.
"When you have multiple people involved, not only captors, but captives, the prime mover creates a system in which people manipulate each other," Welner said. "I wouldn't be surprised if the child was part of that, [where] a threat to a helpless child is used to leverage continued compliance."
At age 14, Elizabeth Smart was held hostage in 2002 for nine months by Brian David Mitchell. Smart says she was also too afraid to try and escape.
"[It] just feels like the whole world is crushing down around you," Smart said in an interview with ABC News in 2011.
Welner was one of the psychiatrists who examined Smart's kidnapper, Brian David Mitchell. Just like the women in Cleveland, Smart was hidden in seemingly plain view while in captivity, something Welner says is common in abduction cases.
"If that person is manipulative enough to come up with a system to inspire fear and dehumanization...[then] fooling and manipulating ignorant neighbors, neighbors who just wouldn't expect something like that, is easy," he said.
"It's easy to understand how Brian David Mitchell was looking right at a police officer and Elizabeth Smart was right there in a library and the police officer says, 'Are you Elizabeth Smart?,' and she remains silent and Brian David Mitchell says, 'You can't lift that veil because we're Muslim,'" he said.
For the three women in Cleveland, as with Duggard and Smart and Hornbeck before them, even though they are free, their ordeal is not over, according to Welner. They next face the arduous and emotional task of recounting their experience to investigators.
"It's very painful for the victims and there's no way around it. You must be heard," Welner said. "You'll assist law enforcement and you'll lock people up and you will make sure they never hurt others again."
"You will discourage others from following in their footsteps, knowing eventually they will be caught and the victim will be heard."