Tuesday, February 08, 2011

Treating Bill Zeller

That's Bill Zeller on the front page of  1000 Memories, a collection of memorabilia sure to break your heart.  Great-looking, a brilliant young man, best known as the creator of MyTunes, an enhancement of iTunes, and Zempt, another technical upgrade, this one for movable type.  A computer programmer with more potential than any one person needs, splashed the news  January 5, 2011 with his suicide. 

He left us a note that does a more than adequate job of explaining why he did it. (It might be good to read that before reading on, not sure.)  He could explain why, but he wasn't a therapist, didn't know how to save himself.  Like most people who take their lives, he had to get out of the pain.  It's so hard to read about a case like this (he's now a case), because not only is the story going to be sad, but there's no happy ending. 

Some people blame bad therapy, which he likely suffered.  He describes detached, clinical treatment.  There's a reason doctors detach, there's so much secondary trauma in this work, absorbing the pain of the patient (you have to be infected some) and living, if vicariously, the trauma.

But sometimes it is the patient who is hurt, call it incest redoux (once again), if he pays for a lack of professional attention, for professional indifference.  Bill Zeller made an effort, took the a chance, played the Lotto for professional understanding, desirous to rid himself of the cloud, talking to the likes of us.  Only to find the cloud follow him out the door.

Zeller was a victim of sexual and psychological abuse. It's clear from his writing that the abuse left him unable to interface with the world in any way that didn't leave him feeling he was too sullied to have the same experiences that he thought others had. He had a self-described "darkness", which despite his prostration it's clear he handled more ably than perhaps he ever realized.

Programming was a solace, but only temporarily. Zeller never felt he could escape the things that had happened to him because he carried his torment with him everywhere.
Yes, it is that painful. Rape kills.

Body memories, terror, an invasion that is gruesome, hurts, overpowers, shames, confuses and traps, sullies, violates, and won't let go.

How does one recover a sense of separateness, wholeness, integrity, goodness-- when someone else has declared possession?  When someone else has enslaved, degraded, etched memories, sensory memories, physical feelings within one's very body, soul?  The self is no longer one's self, but a shared object, something someone has used, over and over again.  Abused.  That's the word.  The crime, heinous.  Taboo everywhere, all over the world, incest.

We talk about wanting to share our life with others, having a partner, joining, intimacy, making a family, maybe.  Where there is an incest wound this is particularly difficult.  Intimacy is going to be difficult at all levels, all of the intimacies are difficult, but especially sexual intimacy.

Therapy doesn't just work with young adult incest survivors who come to us frustrated with efforts at socialization, more than a few failed relationships, feeling the need to meet sexual expectations, human expectations.  And sex therapy doesn't just work, either.  It is a stretch to have what is considered a a normal, intimate sexual relationship when touch isn't pleasure, but is associated with pain.  Initiating touch, or the very experience of another initiating touch, is packed with terrifying memories and dread, anxiety.

This isn't fun, this isn't goodness, this certainly isn't holy or sanctified. It isn't even pleasure for the sake of mutual pleasure, forget the blessings of commitment.  A survivor of childhood sexual abuse does not usually enjoy sex, not without a head trip.  Libido is confusing, associated with shame.  Therapy must address all of the above, all of the trauma, and more:

Who am I?
Why am I?
Why me?

There are many objectives of such a therapy.  Self-esteem, for one.  A fresh cognitive assessment of one's life, two.  Loving oneself, three.  Becoming a social person, four.  Somehow capturing that self and rewiring it, inhabiting the same place, the one with all the memories, in a different way, being inside a shell that must symbolize a new identity.  This is the goal.

The body memories?  How does one get rid of these?  So complicated, that these will remain, lie side by side, parallel to sensual pleasure, but they can.  In the process of reclaiming, redefining, re-identifying self, they must be ignored, as if they don't belong, don't matter.  Willfully set aside, the focus is on a new relationship, a good, loving relationship that needs love back. All in good time.

Working a therapy like this is hard, and a support group or three, has to be a part of it.  Holding onto that new identity, A Survivor, is experiencing the self as clean, good.  Knowing.  A person with something very important, perhaps, to teach others.

It can be very difficult, very painful, very sad, but then, there is a happy ending.

Except not always.  Most survivors suffer from Post Traumatic Stress Disorder, or Acute Stress Disorder, and a myriad of accompanying affective disorders, depression and anxiety primarily.  But incest can make some people so sick that they can never get a grip on a therapeutic relationship, can't sustain one, or so it seems.  One of the ways that children survive incest is to split off, disassociate from the assault at the very moment it is happening, become someone else, invent a second, third, a fourth identity.  Fall into a trance, a happy dream. The goal for a person with this disorder is different, demands an integration of the many identities, or exile.  This is Dissociative Identity Disorder and it is unarguably one of our most challenging disorders to treat. 

Mr. Zeller didn't have it, not from what we can tell from his writing.  Brilliant, it seems he stayed Bill, a guy who played tennis and got good grades and fought depression all of his life.  And lost. 

We don't know if he ever confronted the perpetrator.  If he had, and if the perpetrator apologized, if the animal owned his offense, then Mr. Zeller might have had a better chance at beating his darkness.

Chloe Madanes, the spouse of Jay Haley, a father of family therapy, offers a powerful family therapy technique:
(1) The victim holds court.  The perpetrator is literally forced down on his knees (or her knees).

(2) On his knees the perpetrator begs forgiveness, acknowledges wrong-doings, admits everything. This person is more than contrite, he is disgusted with himself, ashamed, moribund, dying inside for having committed an act that is so perverse, so cruel, taboo.

(3) If the apology is sincere, and if it is accepted, the perpetrator proposes amends.   (I don't remember if Madanes' protocol works this way, but mine does-- apology first, amends later).  After the apology, the perpetrator offers to pay for all of the therapy, past and future, or to pay for a college education, a down payment on a house. Something.
Never happened for Bill Zeller, is the guess, raped by someone repeatedly, systematically, he alludes to it being a family member.  Bill was a little boy, the note suggests the rapes first memories.  Had he told a teacher, had he known to tell someone, he may have been spared.
So we clearly have to teach about child abuse in schools, for that is where the children are.
Child abuse education won't be taught at home, not in the homes that are breeding grounds for this barbarity.  For child abuse is often transgenerational, passed down from one generation to another.  It is learned behavior.  Not always, but percentage-wise, learned. Family therapists see all kinds of gradations, variations on a theme, from one generation to the next, each saying, Mine was worse.

The suicide note, in its entirety,  should be read by everyone old enough to understand cause and effect.  Mr. Zeller requested that it be circulated. He knew that he had something to say, something very, very important, more important than whatever he could create as a programmer, an identity he established to distract from his darkness.

Read it and know that people learn to perpetrate sexual violence from people close to them, that sexual violence is usually a family affair, that 48% of all acquaintance rape is right there, it is in the family, and 90% of all rape is acquaintance rape.

Makes a case, to plug the profession, family therapy. At some point, family therapy.



Anonymous said...

How very sad. I know I have been in major denial about dealing with my family abuse, and what you wrote here, and the way you wrote it, has opened that door to working on it just a little bit more with my own therapist. Good luck to my able therapist in helping me. Thank you.

Leigh said...

I've only just begun to deal with this - from my husbands side. The impact in later years is just unbelievable. Can't say more because it's not my story to tell, but thanks for posting this.

Irina Tsukerman said...

Thanks for posting this... I am surprised to see how much impact this tragedy had made across the blogosphere... Still trying to wrap my mind around it...

Smitty said...

Thank you. I don't know if this makes sense, therapydoc, but I think this young man is one person challenging our mental health model. It is those of us who break and cannot put on the stoic front this young man did... who are being treated. He is the exception... that tells us our system is indeed broken.
This man's story verifies a hunch of mine: that those of us who do break at an emotional fracture line, are fortunate, not weak. Those of us who exhibit mental illnesses, are given of facing our childhood trauma.

I say this, because I would rather be who I am, with my diagnosis (even if I don't agree that the medications are the treatment)... and be struggling to tell my story... than be dead.

Mark p.s.2 said...

Therapy as I understand it, the therapist takes on a parental role, maybe other roles. It is a purchased one. The therapist is doing it for money.

My advice would be don`t look for a new master.
"I haven't touched alcohol or any other drug in over seven months". He wrote.

Drugs can get you in touch with your feelings. Too much drugs is bad of course, but this is a case of too little drugs .

Leigh said...

Mark what is wrong with providing a service for money?

While social norms & market norms do present an awkward situation -- no one is another persons "master," in a therapeutic relationship.

Sid said...

Nice post. Tweeted.

Mark p.s.2 said...

re:what is wrong with providing a service for money?

Nothing is wrong. Just reminding the "patients".

As an involuntary patient, the Government pays the bill so the Psychiatrist (or whoever) are servicing the Government, not the patient, as the patient has no say in paying the bill.

RE"no one is another persons "master,"
I disagree. The money exchanged can be just a detail. The patient is looking for something, needing something or they would not show up to talk. This tends to make them a slave to the holder of the "correct" information/ approval/praise.
Maybe an Oedipus complex/Electra complex.
You cant disappoint your (new) mom or dad can you?

Patricia Singleton said...

Bill's tragedy, as someone called it in their comment above, is having such an impact because there are so many of us who have suffered through the tragedy of child abuse in its many forms.

I am an incest survivor who speaks out to other survivors through my blog. Many of us are beginning to speak out and connect with other survivors. Many can probably relate to Bill's feelings, if not to his actual experiences. I, for one, didn't choose suicide but I can understand why some do. Sometimes the pain just becomes too much to bare and you see no change in the future.

I thank Bill for sharing his story through his suicide note. I will help other survivors. The awareness that child sexual abuse does happen will help others to prevent another child from being abused.

tuesday@11 said...

My heart is breaking for this man. But, that does not help him as he has ended his pain. I wonder what the therapists who failed him are thinking? It must be hard for therapists who truly are gifted in helping hurting people to know there are therapists who suck. I could never be a therapist. Too much life and death responsibility. I thank God for my therapist. I chose her from a website as I was new in town and knew no one to ask. A total crap shoot in choosing her. All I had was a prayer to God to help me choose someone who could help and not cause more harm. Four years later I have a life worth living. After 34 years of marriage I enjoy intimacy with my husband. No more fear, shame, dread etc. Just peace. I wish Bill Zeller could have spent time with a therapist like mine. Thank you TD for bringing these difficult subjects to attention. People need to know no matter what horror you have lived there is help. The key is finding good help.

onelongjourney said...

Thanks for this thought provoking post - you've described some of the after effects of childhood sexual abuse in a way I haven't read before, three years into the process and 40 years after the fact.

Anonymous said...

A good 10% of my caseload is sexual abuse/incest. The secondary trauma you speak of is very present. I have to check myself frequently while counseling.

And it's so true that these clients are so difficult to reach; the memories and convulted emotions that go with being violated in such an intimate way by the very people who are supposed to be nurturing and protecting go so deep that it is it's own kind of challenge. There are so many layers to get through, so much misplaced shame.

I run a group for incest survivor women, and today their main topic of discussion was about how robbed they feel of the person they might have been.

Sometimes, I am speechless, and can offer nothing except a sense of safety for them that is non judgmental.

The collateral damage from this type of violation is almost endless.

"First, do no harm." This is the LEAST I can do as the therapist, and sometimes, also the MOST I can do.

A tragedy indeed. Thanks for the post.

Jack said...

Such a sad story- words aren't enough.

HubCats said...

I was hoping you'd post on this - thank you.
when you say "he played the Lotto for professional understanding" are you saying that he had only a very small chance of finding someone capable of helping him?

Why would he let everyone know the truth only after his death, when he wouldn't tell anyone when he was alive? was it worse that people would think he was crazy?

porcini66 said...

This will stay with me for a very long time...

therapydoc said...

No, no, HubCats. I'm pretty sure that he could have found someone who would have helped him. I really don't know how capable he was, socially, of talking in therapy, or even if the treatment he had was bad! We assume that it wasn't the greatest if he couldn't establish a therapeutic relationship. I probably shouldn't have used that expression, "the Lotto," because you're right, it does imply slim chances.

Most of the therapists I know are really pretty nice, engaging, caring individuals who work very hard to build relationships.

Ella said...

Thank you so much TD, for writing about this!
My provider has started to use the deoression screening quiz at every visit with every client. So, my T and I talked about this suicide. I'm glad that I didn't have the right tools when I felt so dark in the months/years that followed an assault by my host "father" in France.
My family did end up in therapy a few months after this occured, but my parents were the focus. And there were a few false starts with a college counselor, pastoral counselor.
I totally get how Bill might not have found any hope of help in counseling. It was 27 yr before I got useful help.
It definitely sounds like he coded in a disociative state. Very harsh.