Wednesday, March 08, 2006

Is This Really Breaking News?

I'm sorry, but is Terri Hatcher being sexually abused as a child really "breaking news?" As a psychologist, I deal with people who have been sexually abused. Is it hard on them, difficult to deal with, devastating at times? Yes, it can be (or not), but is publicizing all of the victimhood really a good way to help those who have been sexually abused? And frankly, from Oprah to Ms. Hatcher to Angela Shelton, it seems like everyone owns up to some abuse at some point. I can't help but feel this play for victimhood is not a good way to promote healing for the sexually abused.

I remember once sitting in on a group session at a sex abuse clinic for women years ago. I observed the group leader getting the women to open up about their abuse, but frankly, no solutions were put forth. The women cried, moaned and described their abuse in excruciating detail, more info than I ever wanted. One woman could no longer talk and was mute (although doctors told her there was nothing physically wrong with her) because of the severity of her abuse. I observed a number of sessions but noted that no one ever seemed to be getting better--in fact, some seemed to be getting worse--and I decided then and there that the way sex abuse victims were handled and the emphasis on victimhood was not the answer. I later talked to patients who had gone to similar group therapies or been told by mental health professionals or others about how devastating their abuse must have been. Rarely did this seem to help.

I am not downplaying the emotional upheaval that can be caused by sexual abuse, but I disagree with the methods that our society uses to deal with sexual abuse. A person who has been abused often gets the message, if not directly, then indirectly, that they are "damaged goods" or that this one event in their life defines them in some way. Or that if they do not feel pain, vulnerability and damage from the experience, then they must be repressing something. My concern is how to help people overcome sexual abuse experiences and get better, not how to help them wallow in victimhood. If the mute patient in the group therapy session I described above is any example of how one should deal with sexual abuse, by offering victimhood as a lifestyle, then count me out. I would rather see people heal and move on.

64 Comments:

Anonymous Alan said...

If the mute patient in the group therapy session I described above is any example of how one should deal with sexual abuse, by offering victimhood as a lifestyle, then count me out. I would rather see people heal and move on.

If people don't talk about their abuse or otherwise acknowledge it then how can any sort of "healing" take place at all?

I also wonder if you aren't labeling ANYTHING short of effortless adaptation to the psychological injury of abuse as "victimization". Even attempting to grapple with such memories is apt to bring up all sorts of mixed and negative emotions. Is that by definition unhealthy? And, by being so careful not to encourage "victimization" might you instead be promoting suffering in silence or, worse perhaps, a sort of faux rehabilitation where people take out the outward appearance of having "handled it" while leaving the underlying psychological stresses untouched and festering?

Given the tone of your other posts here I have to wonder if you aren't basically advocating that people just need to "get over" their psychological problems as if doing so where merely a simple act of will. If so, I think you are seriously underestimating the difficulties inherent in dealing with this sort of trauma.

11:18 AM, March 08, 2006  
Blogger David Crawford said...

Actually, I think the template of victimhood was first foisted on the world by Alcoholics Anonymous. Don't get me wrong, AA truly helped me when I decided to stop drinking 5 years ago. I took their 12 steps and used it to repair my life.

But, their meetings? My gosh, they were the biggest whine-fests I have ever had the misfortune to experience. I'd feel worse coming out of a meeting than I did when I went in. And I realized that the whole AA meeting experience was an excuse to go on about how each of us was a sad victim of alcohol.

I quit going. If anything was going to drive me back to drinking, it would be wallowing in my own pity at an AA meeting.

12:02 PM, March 08, 2006  
Anonymous Anonymous said...

I for one am sick and tired of celebrities and pols using the abuse revelation as a vehicle for publicity, attention, sympathy oh and always to *help others cope* of course. This has gotten really old. (And the idea that you can talk and talk and talk your way through the trauma is pretty tired too.)

It's too easy and tempting for women to go the confessional route. The whole Oprah-ish world fosters it. Don't know what to say, want to stop the conversation, turn everyone's heads? Tell about daddy.

And I would like to see self-proclaimed victim advocates to make their case WITHOUT using their own personal anecdote as "evidence." Or would that require too much logic and persuasive argument?

Maybe the girl who killed herself heard so often that her life was *ruined* that she actually believed it.

12:05 PM, March 08, 2006  
Anonymous grad03 said...

If talk therapy doesn't work, what methods are more successful?

I can understand and agree with several points in this post, but how can women who have been abused find ways to put themselves back together and lead happy and productive lives? Simply burying trauma doesn't work. Talking it to death doesn't work either. So what are useful methods of dealing with an abusive past?

12:20 PM, March 08, 2006  
Anonymous Anonymous said...

Whether or not they are getting better, I bet they're pronounced "cured" when the money/insurance runs out!

12:21 PM, March 08, 2006  
Blogger jau said...

I'm thinking that talking about it as if it's fairly common is a good way for everyone to take it as LESS victimization. More as something nasty and pretty awful, like really bad acne, but not so much damaged goods as something to live with and get on about. But I disagree that talking is excessive - because like all therapy you can say things a hundred times but it's that hundred and first that "takes" and works.

12:24 PM, March 08, 2006  
Blogger Helen said...

I think talking about sexual abuse is fine--but talking is not enough. Changing the cognitive beliefs that a person has about the abuse is what I have found to help. You can talk for years, but if you believe that the abuse is so psychological destructive that you cannot get over it, then how can a person get better? In addition, the group therapy patient I described was getting sympathy for descibing her pain, not for trying to get better. Yes, she had been abused, but the question is, "what can you do to get better?" I have patients that tell me they cannot do something hard because they are "damaged goods," psychologically damaged or afraid. I say to them, "yes, you may have (insert problem here) but given that you have (insert problem here), how can you reach this goal, etc. even with your problems. It is doing something hard and seeing that they can do it despite being "damaged" that helps people to change, not ruminating over the damage that has already been done. Sure, it is fine to acknowlege and discuss with a therapist--that is what we do, but to spend years talking without insight and changing one's thoughts and actions does not typically make for a better life.

As for the public talking about sex abuse, up to a point, okay, but the incessant emphasis on abuse seems to lead to hysteria. People who look at porn with kids on the internet often get more time in jail than someone who kills a child or adult. The average person starts to believe that rape is worse than murder. We have become a nation obsessed with sex abuse--even to the point where just accusing someone of abuse can ruin their life, regardless of whether or not they are guilty.

12:43 PM, March 08, 2006  
Blogger BobH said...

Helen

You seem to want to promote coping behavior instead of promoting "healing". And I'm not sure that that is bad. In fact, I'm not sure what healing really means to victims of abuse.

Somebody who has been severely abused must estimate the likelihood of being abused again differently than somebody who hasn't. Consequently, abused and unabused people would have different level of trust and vulnerability that they should allow themselves to show to the world around them. (Moreover, there appears to be a probability distribution for how different people act in response to identical levels and types of abuse. Is there any good statistical data on this?) Furthermore, this different estimate is going to affect their likelihood of entering into certain types of relationships.

Does "healing" mean that these abused people have reset their estimates back to the "unabused" baseline? It seems preposterous that people would EVER do that. The best that could be hoped for is to reduce the abuse's emotional salience. The best way to do that might be to distract oneself with something else and simply allow time to pass. And this is precisely what these "therapists" are NOT allowing their patiences to do.

Am I wrong?

12:54 PM, March 08, 2006  
Blogger Helen said...

Bobh,

I think that people can heal from sexual abuse, in much the same way people can "heal" from other emotional traumas. Healing may not mean going back to the baseline before the abuse occurred--but it may be more like a scar on one's heart. The heart may have problems after a heart attack and be scarred but it still works well enough and may even be more resilient than ever. Bad experiences do not have to break us.

I read recently that the old ways of dealing with those with PTSD with exposure therapy and having people relive the trauma over and over is not always helpful. In some people, it makes them worse. Getting better--that is--perhaps defined as being able to be involved in a healthy relationship, trust others who are trust worthy etc.--or whatever the patient may define for themselves--may be a result of incorporating the experience into one's life as something that happened. Yes, it was bad, but can one build on the experience in a positive manner or let it overtake one's life. There is a healthy balance of discussion of the problem with a change in thinking patterns that leads to change. If a therapist focuses too much on the abuse, it may get in the way of getting better, but if time passes and one just distracts themself, no change may occur.

And yes, people react differently to sexual abuse. I have seen people who have survived the worst of circumstances and who still function well and others who had a one time encounter with a flasher who spent years incapacitated from the incident.

1:21 PM, March 08, 2006  
Anonymous Eden said...

I wrote about this, but concerning disclosure of rape instead of childhood sexual abuse, over on my blog today (NSFW)- http://www.justonebite.com/index.php/j1b/after-all-this-time/

As someone who has gone through a few sexually violent episodes, I am very frustrated with those who push victimhood on others. Shows, movies, magazines - they all tell us that we should be pitied, comforted, treated with kid gloves. Women are told that all men are potential rapists and that past abuse is an acceptable excuse for any manner of misbehavior on our part. I believe that too many people find comfort in being the treasured center of attention that a revelation of abuse can provide. They don't heal, they just stagnate there, and they think their lasting anguish is the normal state of affairs.

For me, the key was finding ways to separate the conflicting, difficult emotions and negate them one by one. I did that on my own, which I'm not saying everyone can do, but grief can be balanced by joy, fear by courage, guilt by pride, etc. Talking about sexual abuse and rape is better than hiding it, but the next steps you take are what really make the difference.

2:03 PM, March 08, 2006  
Blogger Helen said...

eden,

Thanks for sharing your experience here. I only wish that I met more women and men, like you, who can work through issues rather than blaming others who have never done them any wrong instead. It always intrigues me how some people tend to generalize their experiences to others and see the whole world or all men etc. as bad. I think if people could view the experience as bad, i.e. it is unfortunate that I met up with a pervert, rapist etc. rather than generalizing to all people--"all men are bad, I can't trust people," it would go a long way towards recovery.

2:27 PM, March 08, 2006  
Blogger Mercurior said...

sometimes going over and over and over the same subject matter can make the feelings more relevant more NOW, yes there is a point when talking works, and a point when talking doesnt. a true professional knows when to listen and when to say, look going over this same thing doesnt actually help you, its just making things more entrenched in your psyche.

its a fine line to tread, and i dont for one moment think any psychologist has it easy (used to work in a psych department of the local hospital and whoa, i admire people who deal with those problems day to day.)

4:28 PM, March 08, 2006  
Anonymous Anonymous said...

I read the Terri Hatcher article in a different light. I thought the point of her talking about her abuse was to put the child abuser (her uncle) behind bars when she found out there were others who were abused by him. I didn't see her as a victim, but as someone doing her part to put a criminal away.

Is there something I'm missing?

5:27 PM, March 08, 2006  
Blogger Sean said...

but Dr. Helen, if these people were cured, or at least taught to cope with their issues they would no longer need the therapy. besides, since the best thing you can be in this society is a victim, what good would it do anyone to take that status away from them?

6:11 PM, March 08, 2006  
Anonymous Teresa said...

I had a friend who went to Al-Anon for help (her parents were alcoholics)... she said roughly the same thing David Crawford says in his comment. She just couldn't get over how the meetings consisted solely of people crying and moaning about how hard it was to deal with the alcoholics in their lives - there were never any solutions offered or any suggestions of ways to help make life easier (short of intervention which turned out to be an unmitigated disaster in her family's case). She just quit going and worked through it in her own way.

I have a feeling that the same thing happens with sexual assault victims. There is no effort made to empower them - to show them that they can and do have control of their lives and can actually improve this. That's the saddest thing of all - they remain victims and the predator wins.

Anon 5:27 - Terri made her statement without her name ever being publicly released. She could have kept it that way - but decided to talk to Vanity Fair instead. Not surprising as every celeb seems to think we should know every detail of their lives....

I haven't read the article. I could see it helping if she takes the track of - "I was abused and look what I've accomplished" (after all she has had a terrific career). If, OTOH, she takes the track of "poor little me" then she helps no one.

6:35 PM, March 08, 2006  
Anonymous Shelly said...

The incessant need by some therapists and some victoms to review over and over the details of abuse are not helpful in moving on with your life. It is like constantly picking at a scab, the more you pick at it the more you bleed and the more it hurts and the less it heals. I can speak about this with a great deal of experience. I was sexually abused by my grandfather as a child. Guess what - as a childhood experience it really sucked. Did I need to dwell on it over and over again as one therapist tried to get me to do? No. What I needed to do was accept that a bad thing had happened to me. I was not a bad person just because a bad thing happened, and to then be allowed to move on. I have managed to block out a lot of the details of what happened to me. I like it that way. I do not need to constantly revisit those scenes in my memory. Most therapists out there want you to revisit the bad things in an effort to "help". That did not help me. Being told that it wasn't my fault and that yes it did suck helped. It also helped that I grasped a basic understanding of life at an early age, Life isn't Fair. Bad things do happen to to good people. You know what did help, being allowed to get over it. Being allowed to pretend that it didn't happen and that I was just as normal as any other little girl out there. I am now a happily married successful individual. I do not identify myself by a label of Sexual Abuse, I identify myself as being a happy, healthy, responsible member of society. After all isn't that what we should all try to become?

6:51 PM, March 08, 2006  
Anonymous Anonymous said...

My opinion!

http://www.angryharry.com/reTeaAbuse.htm

6:56 PM, March 08, 2006  
Anonymous Anonymous said...

How to ruin a person's life ... convince them that the benign mole on their back is a truly horrible malignant cancer.

7:13 PM, March 08, 2006  
Anonymous Vicki said...

A one-time molestation at age 10 reinforced, for me, what I had already learned all too well: that the world is a scary place because there are people who don't mind hurting others, for no reason. I never mentioned it to anyone for six years--not a good thing. I finally started telling the occasional person in my late-20's, when there seemed to be some reason in the conversation. Later, I talked about it in various in support groups and in individual and group therapies. The emotional level dropped most when I did something physical, e.g., beating all h*** out of a pillow or stuffed chair. *But*...

One day, in talking about another issue, my therapist asked what significant events had happened around that time, and I named a couple, including the molestation. Finally I said, "You know, I am so tired of talking about this, and not really getting anywhere!" That very day, he helped me change my thinking about it: It wasn't my fault, it wasn't my parents' fault, it wasn't God's fault; it was the act of one man who made a conscious choice to do it. Period. *I'm* the one who let it affect me for so long.

So I quit letting it affect me. It happened. Boom. It's over. Boom.

I will say, I'm very thankful the experience itself wasn't a lot worse. My pain was emotional. Residual physical consequences serve as a constant reminder, and I can imagine that makes the challenge of getting better and moving on a whole lot greater.

8:44 PM, March 08, 2006  
Blogger Mark Daniels said...

Great post! As a pastor who does some counseling and who works in concert with psychotherapists seeing parishioners I refer to them, I agree with your assertion that far too much emphasis is placed these days on revisiting and regurgitating past pain. The result is often far from cathartic. In fact, such methods often result in an unhealthy dependence on the painful episodes as getting attention or establishing a personal identity.

I'm not advocating sweeping things under the metaphorical carpet, of course. But once sources of difficulty or pain are identified, the task should be on changing the present and the future, not wallowing in the past.

Mark Daniels

11:05 PM, March 08, 2006  
Blogger Mark Daniels said...

By the way, a friend of mine once dated a woman who had been in therapy for something like fifteen years. She went from therapist to therapist, finding new docs on whom to dump her story. She was totally "stuck," as they say, unwilling to move on with her life. In the end, she and my friend broke up. She was too intent on living in the past to actually be happy.

11:12 PM, March 08, 2006  
Blogger jw said...

I think we'd get a lot of answers about talk therapy from the Canadian experience. Under Canada's various human rights laws all males are defined --for purposes of trauma victimization-- as not human enough to be worthy of treatment: All government and institutionally funded treatment centres are female only. All research programs are women-and-children only and run by the most rabid man-haters available. Somehow, boys are not "children" in the eyes of these research centres.

Males must cope alone. That's the law. If our government were to spend some money to answer the question "How do male and female Canadians do after treatment?" we would get a good answer to the prime question "Does current treatment work?" NOTE: The three centres who do treat males are privately funded and for fee; they also have waiting lists many times longer than the women's. NOTE ALSO: There's zero possibility of the study being done as the study would highlight the bigotry of the system which might break into Canadian pride in defining males as non-human.

As a survivor, I place the rape in the same category as my tremor and my chronic dry eyes. These are problems I live with that are only problems. They go on their mental shelf and only have impact on my life in restricted areas.

That said, the hatred of men & male survivors! The sexism, the outright bigotry ... THAT, that causes every day damge. That is an every day hurt which causes damage every day and has no solution as Canadians are VERY proud of the damage done to male survivors.

I don't pretend to know what is the right way to treat abuse issues. Dr. Helen's "learning to cope" sounds good. At least any learning sounds better than endless repeating of painfull stuff.

4:31 AM, March 09, 2006  
Anonymous Anonymous said...

Isn't "talk therapy" kinda like constantly picking the scab off of a wound?

5:35 AM, March 09, 2006  
Blogger Helen said...

JW,

I am saddened to hear that Canada does not assist males with the same rights and treatment that females have access to--I have found that sexually and emotionally abused boys are a very rewarding group to treat as they really respond well to therapy if the therapist is experienced etc. I spend most of my time evaluating boys and men, mainly because this is my interest, but also because it is so desperately needed. I talk to boys everyday who feel the system does not understand them, they feel isolated and alone. I cannot see how the Canadian Health care system could overlook such an important demographic.

6:32 AM, March 09, 2006  
Blogger jw said...

Dr. Helen said "I cannot see how the Canadian Health care system could overlook such an important demographic."

It's easy for them. They simply say "Anyone with enough money in their pocket can access talk therapy." Plus, they point to two booklets written 15 or so years ago, (they do not point to the several thousand booklets, movies & books for women).

The whole argument is both true and false. True in that enough money will buy access to something like therapy. Untrue as no amount of money will buy the care & concern which is female only: Untrue as there are believed to be only three psychologists trained in male victims in the whole country. Plus,a great many --probably most-- males cannot afford any form of therapy, which is free for all females.

Worse to me, is the pride in the harm done. I liken it to real and deep abiding joy in harm done and it is getting rapidly worse.

Sad really: I'm sure it causes some of Canada's suicides.

11:38 AM, March 09, 2006  
Anonymous Anonymous said...

Take 10 people and have them jump off a 10 foot high platform onto the ground. Would we be surprised if some of them were not hurt at all, some were bruised up pretty well, maybe a few broke ankles or even legs, and maybe even 1 or two suffered paralyzing injuries? Of course not . . . we would understand. Even though each of the 10 EXPERIENCED THE SAME THING they are all physically different and therefore the result will be different.

Why then, Dr. Helen, is it difficult to understand why some people "just can't get over" being sexually abused while other people can "get on with their life" ?

I like this blog, and I respect your opinions, but I shudder a little if you, as a mental health professional, really do take what seems like a cookie cutter approach to your profession.

4:24 PM, March 09, 2006  
Blogger Helen said...

anonymous,4:24,

Yes, that would be me--a psychologist who takes a cookie cutter approach to my profession. The cookie cutter approach it seems to me, would be to say that everyone must be damaged by being sexually abused--and treat them as if they are, whether or not this is true. This has been the take of most mental health professionals and society. I understand your concern that there are individuals who need to be treated with kid gloves by a therapist to help them in their recovery but--please tell me how it helps a person to be told by a therapist that they are a victim, cannot get on with their life and their life is ruined because they were abused?

4:52 PM, March 09, 2006  
Anonymous Anonymous said...

I wonder if some folks just enjoy the victim status? The list of victims in endless. I'm not sure if there are any people left in the country who do not qualify as victims.

Half the population are women and are victims of sex discrimination. 13% are black and are victimes of racism. 14% are Latino and are victims of racism? A million men served in Viet Nam and are veteran victims. Gays are victims. So are transgendered. Muslims are victims. Jews are victims. The functionally illiterate are victims. So are people without internet connections. The bottom quintile of earners are victims. Drug addicts are victims. Alcoholics are victims. Walmart employees are victims. Investors who lose money are victims.

Have I victimized anyone by leaving them off the list?

6:10 PM, March 09, 2006  
Blogger Helen said...

anonymous 6:10:

I agree that there are a lot of victims in this country--unless you are a white man or a Republican or Libertarian woman in which case you are an oppressor or heartless. I guess the more victims, the more nanny state government, victims groups, advocats, etc. that we need and the cycle continues.

6:42 PM, March 09, 2006  
Blogger Mark K. Sprengel said...

Is part of the problem that emoting and drama provide instant feedback that one can easily mistake or assume is progress? That and such displays are considered more genuine in some way?

8:35 PM, March 09, 2006  
Blogger Assistant Village Idiot said...

mark, you have hit on an important point here. There is often a drive or desire to express things, a subjective feeling that retelling them will work somehow. And there is often a release of tension, a feeling of solidarity with others, and some warm attention that goes with the retelling, all of which are rewarding.

What we find is that in the long run, unfocussed "sharing" doesn't work. It does make things worse. But the act of retelling is often temporarily rewarding. What Dr. Helen and several commenters have referenced here is a "focussed" talk therapy, that is less involved with what it felt like (Bad. Duh.) than what can be done to manage overwhelming feelings or reframe helpless attitudes.

I wonder about the false dichotomies that keep coming up in the comments sections of the psychobloggers -- that any suggestion that marinating in your feelings is not helpful is interpreted as a denial of pain and a cold-hearted rejection.

People need to be told that they're basically strong. Our ancestors endured enormous traumas, and we have their genes. They felt pain, just as we do -- and yet produced us.

11:19 PM, March 09, 2006  
Anonymous Vicki said...

The Non-Sequitur (?) comic strip appeared several years ago with a man on the shrink's couch. He was recounting a dream in which it was found that everyone, everywhere, had been a victim at some time; therefore, everyone was encouraged to just get over it and stop living as a victim, and stop blaming everyone else. When he finished, the shrink wiped a tear out of his eye, saying that had been beautiful: "Please tell it to me again!"

Think we can sell it?

12:08 AM, March 10, 2006  
Anonymous Anonymous said...

I was sexually abused/raped as a young teen by my psychiatrist.

Who exactly am I supposed to go to now for 'talk therapy'? Because I can surely tell you that NOTHING even vaguely associated with psychiatry is ever going to be trusted by me. It is up to me and me alone to deal with what happened.

My biggest problem for a long time was that I wanted to label what happened to me. Was it rape or sexual abuse? I am certain that seems crazy to lots of people but that was a big deal to me.

I finally realized that the only reason it was important to put a name on it was because the confessional society we live in seems to make you have to have a specific thing you were a victim of.

Regardless of what it is called what happened was WRONG.

But at the same time it is OVER.

And I need to leave that in the past and move forward with my life not allowing the illegal actions of another define who I am. Because while wallowing in victimhood might feel good and comforting in the beginning... it never gives you a chance to shine.

2:04 AM, March 10, 2006  
Blogger jw said...

I fail to see how, as was so well stated by annonymous 2:04, "wallowing in victimhood" would do anyone any good.

Really. Think about it. How would telling and retelling my story do anyone any good? The few times I have told the story, I felt worse afterwards. Plus, I don't like feeding people's purient desire for rare-crime stories. To me, it is enough to say that "this" happened.

Now if talk therapy could help me see others as caring individuals ... that would be nice. I don't see how that is possible given the day-to-day proof that it is not true (in selected cases) but I'm up for it if it could be done.

There's a lot, I think, that could be done by talk therapy. Working on fixing problems in the survivor's behavior being one. For some, learning not to define themselves by the crime/victimization would be very useful.

The thing to think about, as I see it, is "what actions create the maximum benefit?"

4:46 AM, March 10, 2006  
Anonymous Anonymous said...

Yes, talking about it is good, but only to a point. After that point, it's just wallowing in self-pity, and my own experience is that that only makes matters worse.
/
My childhood abuse was not sexual, but it was almost as traumatic. For the rest of my life since I finally got out of that hellhole I called home, I have had to deal with memories coming up out of nowhere. In my late twenties, only a few years after leaving home, it got to the point where those memories would leave me shaking. I finally saw a therapist, who took me through those memories and told me that one had to "change the record," as it were. She taught me to take those memories and CHANGE them, let them run to a particular point, and then mentally let go with both barrels at my abusive mother. In that mental "movie," I learned to defend myself verbally, and physically if need be. And it WORKED. I was not permitted to wallow in victimhood, but was taught to leave it all behind.
/
No, it wasn't easy. There were a lot of tears and uncomfortable sessions, but the night I had the dream of being at my mother's funeral and kissing her cold body, saying "This is for what could have been," I knew it had been worth it.

5:15 AM, March 10, 2006  
Anonymous Myssi said...

Having healed and moved on and having a friend who hasn't quite managed it yet, I know that you are right. Clinging to victimhood doesn't change anything.
My abuser was a cousin who babysat me in my early adolescence/his young adulthood. Long after it was over, when I was in my young 20s he asked me why I had put up with all the sh*t he'd put me through. I looked straight at him and said "Because I've always loved our parents more than I hate you, and knowing what you've done to me would kill them. They would never get over that they trusted you to take care of me and you didn't. If you knew you were putting me through sh*t, why did you do it?" He didn't have an answer and I've never spoken to him again. But that one confrontation gave me back control of my life. I wasn't scared of him anymore and I knew that what I said to him was true. I valued (and still value) loving other people more than causing him pain and that choice led me to healing.
I told my friend the other day that wallowing in what happened to her as a child was only keeping her from living now. Life's fun and I want her to join me, but she can't until she takes her life back by letting her pain go.
Myssi

10:43 AM, March 10, 2006  
Anonymous Anonymous said...

I think there are some big misconceptions here about what "talk therapy" is and does.

First, that phrase isn't specific enough. There are zillions of philosophies and methods that fall into the category of "talk therapy".

The major idea of psychodynamic therapy is that during the talking, you are building a relationship over time. As you build this relationship, you are able to create trust. In that space where you have trust, you learn to feel safer and you learn how to express yourself--your thoughts, your feelings. You learn also to moderate your behavior as you maintain this relationship over time. That relationship itself, for whatever reason, helps people heal. Perhaps it's that they are feeling heard. Perhaps it's that they are able to reflect on themselves and then practice their new thought patterns over time. Perhaps it's that they are safer and therefore able to make more realizations than they would if left on their own to their own minds.

A good psychotherapist participating in talk therapy creates that relationship by doing all sorts of other kinds of therapy too--a bit of cognitive therapy here, some behavior modification there, some psychoanalysis here. So, in the short term, you're handling the crises in your life with some concrete steps, while you're building this relationship and increasing your ability to cope with reality.

One talk therapist isn't the same as another. One relationship isn't the same as another. If one therapist can't seem to understand your problem, then the relationship won't progress, and you won't get better. They may ask you to relive your victim status, or express terrible details in a way that leaves you wallowing. Another therapist, with whom you've built that relationship may allow you to talk about those details when they seem appropriate to you, and this time, instead of wallowing (for whatever reason) it feels like a breakthrough.

re: wallowing: telling someone they are wallowing is a death sentence to some people, and is enlightening to others. To some, it just points out that their frozenness, brokenness, and inability to cope is now their own fault, and if they were not broken they could "just stop it". For them, telling them to "just stop" is even more increasing of despair and hopelessness than anything else. They need something different from therapy than a person for whom saying "you're wallowing; just stop it" is enlightening. Those folks can hear that and receive permission to merely live their life.

A good therapist recognizes the difference between these two patients over time (by building that relationship) and responds accordingly. One size does not fit all.

11:07 AM, March 10, 2006  
Blogger Helen said...

Anonymous 11:07,

There is a world of difference between telling someone directly or indirectly to play the victim card when it comes to abuse--than to tell a patient they are wallowing. Therapists and society who promote sexual abuse as victimhood lifesytle may cause more damage to the person who has been abused, not less. Victimhood as a lifestyle is not telling patients to "stop it"--it is teaching them to revel in this lifestyle. I have to say that I have seen more than my fair share of incompetent therapists and sex abuse "advocates" participate in this perpetuation of victimhood and it serves no one well, except for the advocates and their ilk who can feel noble about their causes.

11:36 AM, March 10, 2006  
Anonymous Marie said...

I don't have any anwers, but do have a comment.

A dear friend of mine, who is in her mid 50's now, was a fun, busy woman, head teller at a bank.

After a robbery, in which she had a gun pointed in her face, she began to experience depression and some fits of crying for no apparent reason. She went to a therapist and 'discovered' that she had been molested as a child. It had nothing to do with the trauma of having a gun in her face, no it was molestation that she supposedly experienced at age 3!

In fact, everyone she knew had molested her, including her own mother and sister, by the time the therapist had done a year's worth of work. My friend had to quit her job and go on disability. She's on drugs that make her personality more frail (she's frightened of so many things now). She's cut herself (something a woman did in 'group' and she picked up somehow). She does 'group' three days a week and believes now that she has MPD - not surprisingly someone else in 'group' thinks they have MPD.

She's been in therapy now for 13 years. She's not better. She's not been getting better. I doubt that the therapy has done a thing for her except make her a victim and I'm not sure she really was molested by anyone. But she firmly believes she was so what can I say? I know better than her professionals?

NO ONE in her regimine of psychiatrists or therapists (she's had a slew of 'em over the years because she's now disabled and she is stuck with whomever she gets) has done a blessed thing to actually help her. It makes me so angry that she went from being an active, happy, busy and productive woman to a mousy, sad, unhappy victim. Our phone calls used to be such fun; for the last 13 years its been a long list of what she's 'learned' in therapy, or what new pill the psychiatrist has her on now, all told in a little-girl voice. I have to say its tragic that there is no end on the horizon. And she's no closer to being better than she was after the first session.

12:20 PM, March 10, 2006  
Blogger BobH said...

Marie

All I can say is Google on "Elizabeth Loftus" and start reading!!! She's spent much of the last decade (or more) debunking what that therapist is doing. Your friend may also want to see a good lawyer about a malpractice lawsuit.

1:42 PM, March 10, 2006  
Blogger darkbhudda said...

if they do not feel pain, vulnerability and damage from the experience, then they must be repressing something
Soldiers sent on peacekeeping missions are reporting the same thing. There is compulsory counseling on post traumatic stress disorder(PTSD). People who are perfectly fine with their experiences then begin to wonder if there is something wrong with them for not suffering from PTSD as suffering from PTSD is pushed as the norm. This anxiety can lead to the exact same symptoms.

5:15 PM, March 10, 2006  
Blogger Assistant Village Idiot said...

Marie -- what bobh said.

I see much less of this than I saw ten years ago, when uncovering past abuse was all the rage. I have never seen full-blown MPD (now called Dissociative Identity Disorder and describing a spectrum rather than a state, which is something of an improvement) that I did not believe was therapy-induced.

As to combat PTSD and our current soldiers, the VA psychiatrists I have heard speak recently are pretty savvy about what symptoms are temporary adjustment problems moving from a hyperalert situation to a civilian existence, and which bid fair to be more chronic. Premorbid functioning, amount of trauma witnessed, and substance abuse are contributing factors to the latter. But framing the symptoms as adjustments rather than pathologies does help people get over them faster.

I don't know if the whole batch of VA psychiatrists are up to speed -- I suspect not -- but I've been encouraged by what I've heard.

11:28 PM, March 10, 2006  
Anonymous Marie said...

Ass't Villiage Idiot and bobh:

I thank you for your thoughts. I know about false memories. The problem is that for 13 years this crap has been fed into my friend's head. Its now her only identity. How can I make her understand that for 13 years she's been crippled by the multiple therapists and psychiatrists? I now live 12 hours away by car and only speak to her once a month anymore. What can I possibly say that would convince her that her life has been wasted all this time, and not cause her to want to kill herself again? I've thought of this over & over and don't see any way around it.

But I don't see any real value to the 'group' mentality, which I don't think was clear in my post (I've been angry for so long). Every time she encounters something new in 'group' she suddenly has it. Cutting. Suicide. MPD or whatever its called now. I suspect, just by our many conversations over the years, that its become a kind of "Victimhood 101" for her, giving her new roles to act out in the drama class of her therapy sessions. I don't see the use of it, but her therapist still insists she 'needs it'. How can I compete with them? In a strange way, I think the state-paid therapists & maybe the psychiatrist use people like Priss to keep a pay check - I mean - with all the folks she's seen, why hasn't a single one stopped the nonesense and given her the help she's really needed - except that it pays them? (Its all I can come up with, however unfair the judgment may seem to professionals)

I don't know how to help her without hurting her more. After so long, would she even believe me?

11:45 AM, March 11, 2006  
Anonymous flawedplan said...

As a consumer/survivor/counselor and activist I have to wonder how thoroughly you've researched this issue. Far from wallowing in an abusive/blaming identity, kids who grow up molested are more likely to manifest attitudes of protection and loyalty toward their abusers per Stockholm Syndrome. I also wonder about your reference in the opening post to allowing this "one event" to summarize the victim's phenomenology. Where does that come from? Sexual abuse tends to be chronic. Even when it "only" happens once, the threat is from that point on, eminent.

As for this--

"I described was getting sympathy for descibing her pain, not for trying to get better. Yes, she had been abused, but the question is, "what can you do to get better?"

What do you mean by *better*? Such language fairly screams "empathic failure." You evidently do CBT, is that right? Good, stick with that, where you can engage in an arrogant error-correcting stance and leave the psychodynamics up to the client-centered Rogerians who are capable of building a genuine therapeutic alliance.

7:49 PM, March 11, 2006  
Blogger Helen said...

flawedplan,

Is your name a description of the treatment you do as an activist?

8:21 PM, March 11, 2006  
Anonymous Anonymous said...

The very fact that various psycho-therapies take years to achieve what they aim to achieve is, surely, an indication of just how useless they are.

10:04 PM, March 11, 2006  
Blogger Assistant Village Idiot said...

Children do often protect their persecutors, and this sometimes persists into young adulthood. I don't see it much after that. Even so, it would still be possible to marinate in the resentful feelings indefinitely.

Even an unhappy role has predictability, and it is difficult for any of us, not just trauma victims, to move into uncharted territory. Battered women return to abusers partly from rescuing, but mostly from a belief they can't make it in another situation. For those standing on the outside, the misery that people seemingly embrace seems impossible to understand.

flawedplan, you are giving better evidence for Dr. Helen's approach than you would like. You revert to language such as "screams," and make accusations of arrogance for an entire school of thought. What you evidently prefer has a poor track record. People persist for years thinking they are on the verge of breaking through with these therapies, but all they have is more anger, and more dissatisfaction with the way they have been treated by everyone (though they may over-idealize a few for awhile).

I worry that you may not be ready for this, but others need to hear it: Consumer/survivor/counselor/activist is not a good title to take to oneself. It suggests permeable boundaries and over-identification.

I have seen many people stuck, and I have seen many people improve. I've been doing this for decades and see strong patterns. I may not be always right, but I'm pretty darn sure that eithor/or thinking is wrong.

10:57 PM, March 11, 2006  
Blogger BobH said...

To Assistant Village Idiot - 10:57 PM

Your second paragraph sounds like "Decision making under conditions of uncertainty". No bad how things are now, they can always get worse. This isn't just something that abused people (women??) have to cope with. They teach this sort of thing in business schools and I think Vernon Smith and Daniel Kahneman shared a Nobel Prize in Economics for studying applicable biases in human thinking.

9:24 AM, March 12, 2006  
Blogger Assistant Village Idiot said...

Gee, I'm smarter than I thought.

Yeah, that was what I meant all along.

6:57 PM, March 12, 2006  
Anonymous Anonymous said...

I think we are missing something. It helps many people to heal from their abuse to talk to SOMEONE about their abuse. That puts the experience into a relationship. If the listener is worth their salt, they help by listening and providing a relational context for the event. Seeing other people cringe when I discussed my abuse was very enlightening for me. I would not have been helped by talking about my abuse in an empty room. But I was helped by friends and therapists whom I talked TO and WITH.

So much so that I rarely talk about it now. Because I really don't thank about it much any more.

Trey

4:15 PM, March 14, 2006  
Anonymous Anonymous said...

At 11, I was drug into bushes and assaulted. My parents sent me to see a counslor who told me that since pentetration did not occur I wasn't really assaulted and not to worry about it.

As a teenager I had a fairly serious drug and alcohol problem for which I was sent to rehab. I stayed sober for 12 years w/ AA.
My life was not improving. I was stagnating. AA, although it did help stay sober, didn't seem to be helping me move on.

In my mid-twenties I began seeing a therapist. Although I was still not drinking, I was in a physically and mentally abusive relationship (okay, affair) with a married man and wanted help figuring out how to fix the relationship. Ugh.

Liz, the counseler, told me that I was much stronger then I gave myself credit for. (Who knew!) She said I had the absolute power to change my life. It was entirely up to me...I could continue focusing on how lousy my life was or I could make a conscious decision to change/improve it. Finally, she added that my bad choices was allowing those boys from all those years ago to rule my life.

And now? I'm finishing my last year of law school. I'm happy and healthy with a great group of friends. Turns out I wasn't an alcoholic so much as I was hiding in AA meetings So, no more meetings but occasionally I do drink, and I do mean occasionally.

I fully support counseling as it helped me more than anything. But the counseling was focused on consciously taken action not re-living or re-hashing the past. There is a huge difference.

cbi

12:40 PM, March 15, 2006  
Anonymous Anonymous said...

---The very fact that various psycho-therapies take years to achieve what they aim to achieve is, surely, an indication of just how useless they are.

WHAT???? It took me YEARS to become an adult with the thoughts, patterns, and experiences I had. Why the hell would it be quicker to fix?

Think of it this way: I injured myself over and over again in word, thought, deed, and feeling. Just as an injury needs to heal, so did I. 15 years of injury doesn't heal until you stop reinjuring yourself--and maybe then with physical therapy, it could still take years to heal. These psychic injuries are similar.

I agree there are many incompetent therapists out there. But Dr. Helen, you haven't told us how to find ones that aren't. Your response to FlawedPlan and Anon 11:07 really ignores that some of us actually DO need emotional support in order to heal.

Psychodynamics isn't equivalent to incompetence. Recognizing the difference is difficult, assuredly, and newsflash! much more so for patients. But if you can't tell us how to distinguish, how the hell will we figure it out?

11:17 PM, March 15, 2006  
Anonymous Jack said...

I think David Crawford's post is way off the mark. "But, their meetings? My gosh, they were the biggest whine-fests I have ever had the misfortune to experience. I'd feel worse coming out of a meeting than I did when I went in. And I realized that the whole AA meeting experience was an excuse to go on about how each of us was a sad victim of alcohol." To me, the purpose of the meetings is to hear the various stories of how alcohol addiction almost ruined lives and how people were able to see the light and stop drinking. Victims? No, just one alcoholic talking to another to try to keep them sober. I've been in AA for many years and I've never come across a member who thought he was a victim. The tone of meetings is positive, not negative in that people are whining. I'd say that most people coming out of a meeting feel much better than before the meeting; it's siimilar to going to church.

11:12 PM, March 25, 2006  
Anonymous Anonymous said...

That's a great story. Waiting for more. here

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