Child Sexual Assault: A Different Paradigm

May is Mental Health Awareness Month, and what better way to promote that than to discuss a successful therapy. Thanks to the American Psychological Association's Annual Mental Health Blog Day (today, May 20) for keeping us current.

APA Mental Health Day

APA Mental Health Day

Onto the case study.

This is about Ziv Koren, who at the age of six became the sexual obsession and conquest of her uncle, remained an extension of him for ten years. As in the case of many pedofiles, entirely possessive, the abuse blocked Ziv's social and psychological development. Her identity remained in no-man's land as did her sense of self, even after the abuse had stopped.

She had six years of unsuccessful therapy (Ziv suffered addictions and a plethora of disorders), until she met Dr. Rachel Lev-Wiesel, a professor and childhood sexual assault specialist at the University of Haifa, in Israel. Dr. Lev-Wiesel is director of the Graduate School of Creative Arts Therapies. (For another synopsis of their work together, click here).

Rachel asked Ziv to draw her feelings, her experiences, and this became the vehicle for communication, a process of externalizing pain and telling the story. The doctor and patient published a book together, a near complete transcript of what happens, psychologically, when a perpetrator steals a child's body and mind. It is a picture book. Ziv's art tells the story. When when it is finished, we are treated to the therapist's contribution to mental health, a gift that will change the way many will perceive and approach the treatment of child sexual abuse for years to come, a new paradigm, new ways of seeing this inhumanity. She refines her research in a mere twenty pages.

When Time Stood Still by Rachel Lev-Wiesel and Ziv Koren

Nowhere, not in any of the data bases I've scoured for the latest treatments of sexual assault and pedophilia, have I read the word, "soul". If I did, it was in passing, perhaps soul-less behavior, assault; not a core construct for therapeutic intervention.

But of course this is about stealing a soul.

Rachel Lev-Wiesel, has no issue using the word and discussing the existential experience of assault victims who lose their identity to their perpetrators, and dissociate from their bodies, the bodies that betrayed them. Citing numerous studies on dissociation, she reiterates what most therapists already know. Dissociation is a process that enables sexually abused children to survive abuse. The conscious mind detaches, disconnects from reality, the thoughts, memories, feelings, and acts in the here and now. The onslaught of pain is avoided as reality is put in its place, far away. The soul, or self, or mind, consciousness, whatever you want to call it, is entirely separate from the body, from the event. Identity confusion has to follow, will take years to coalesce, healthy relationships difficult to maintain.

Paradigms about what happens to us during any emotionally upsetting, memorable, traumatic event are referred to traumagenic, and they are not new. At the core of psychological injury, Finkelhor and Brown (1985) categorized four dynamics: traumatic sexualization, betrayal, stigmatization and powerlessness, all associated with victimization, characterizations that have helped those of us in the helping professions to work successfully with survivors. Dr. Lev-Wiesel builds on this theoretical framework, and mental health professionals should be listening.

We need more words, easier words, to work with in treatment.

Those last twenty pages of When Time Stood Still deliver, and the first 147, Ziv's story and art, move us as if we are there, doing the treatment, feeling the pain and the progress. It is an art therapy, and for those of us who haven't ever tried this treatment modality, certainly worthy of considering when words simply don't mean enough. Ziv Koren's drawings are the heart of the book. The pictures aren't pretty, but the art is what art should be, the great communicator. The verbal therapy is via email, a discussion of pictures, and we have the transcription.

Dr. Lev-Wiesel's theoretical framework, however, tells it all. Here is where the concept of a soul's homelessness resides. She explains that most of us see our homes as shelter, safe, predictable places, points of departure and return. The body is similar in that it is the shelter of the soul. The soul is loosely defined, and we might substitute sense of self, other words, but if the body is the soul's private space, and it is invaded, unprotected, that sense of safety is corrupted, ruined.

We all have strong reactions to breaches in personal space. In the case of sexual assault, especially chronic, prolonged sexual assault like incest, the body is no longer safe. It becomes a prison.

What's a soul to do? There are options, Dr. Lev-Wiesel teaches us. (1) Identify with the aggressor (take his identity), (2) split off with dissociation, become oblivious to the body and its needs, and (3) retaliate with punishment for betrayal. This we're all familiar with, self-injurious behavior, substance abuse, eating disorders, promiscuity, addiction to sadomasochism, neglect of hygiene, depression, etc.

No, not new to those of us who work with victims. When the body fails to protect, when it has caved to coercion, an act of self-preservation, it becomes repulsive, contaminated, worthy of self-abuse, self-punishment.

And soul's homelessness is only the first of five exquisitely conceived traumagenic constructs.  Over time we will revisit the others, captured in time, the present and future become reflections of the past; re-enactment of abuse, or time cycling; the betrayal entrapment; and entrapped in a distorted intimacy.

Valuable stuff for not only therapists, but victims and survivors as well. A new appreciation of art, one we won't get in Art History 101.

There is much to be positive about this May, Mental Health Month.

therapydoc

More on Ziv Koren's art and her therapy, click here.

Ziv Koren's art

Ziv Koren's art

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.

Gizmodo:

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.

therapydoc

The Mamas and the Papas Indeed

California Dreaming?

I'm not feeling sorry for myself, but it's been four months since I've seen my West Coast kids and grandkids and that's a little long, even with Google-vid and chat, texting and email. Even with those pictures that pop up everywhere. Nothing helps when I get like this.

Although talking, especially about things that are intimate, helps tremendously.

Over the phone my daughter tells the story about my five year-old grandson,

"Mommy! I put a birthmark in my book!"

Undoubtedly, the stuff of the Mommy Blogs, and you can laugh at the telling, but I would have loved to have been there. I understand his Mommy had a hard time keeping a straight face.

We can talk about our marvelous virtual world, how we keep in touch and all that, but there's nothing like the real thing, the real humans. The touch of your children, the smiles of their spouses, the hugs of your grandchildren.

We'll get to Papa John in a minute.

It cost me a few bucks in gifts, not bad at all, especially since Southwest takes the bite out of baggage, doesn't charge. They're so funny at Southwest, so laid back. None of the attitude:

You're dirt, why should we even let you stand-by.

It's all:

Chill out. We'll get you there.

And there are plenty of places to plug in devices.

So I filled a nylon duffel with various throwing things cuz the kids like to play catch with me, and real kid toys-- puzzles, Disney-Rummy, nothing too expensive. September, birthday month, passed uneventfully so there had to be a few cards, too. Cards are a big deal in our family. You can forget the present, but it's unforgivable to forget a card. I didn't forget, just didn't get to it.

I always freeze, too, when it comes to what to write in them. Maybe everyone does. My solution is to edit the Hallmark text, flip it to get it right.

A favorite pen in hand, I went at it at the airport, two hours to kill. My chauffeur had to make it to a class.

I wanted to buy a magazine, too.

When I told my chauffeur that this was the plan, a latte and a New Yorker, he asked me why we canceled the magazine subscription.

"I couldn't get a good waiting room rate. One thing about The New Yorker. It's going to cost you."

But the cover, all about Iran and the economy, did nothing for me. Not the story about the gangs of Rio, either. Must be a plot to ensure that Chicago gets the Olympics. Chicago and Rio are the top two contenders. And the winner is. . .

We find out tomorrow. Apparently the city that hosts the games will suffer from a plethora of special, but empty new warehouses and big buildings when it's all over.

I picked a different magazine altogether, US, all about fashion and celebrity gossip. Wouldn't you rather look at models and movie stars? The boasting front page:

Mackenzie Phillips' Horrifying Confession.

Who could resist such a thing? And a buck cheaper.

If you haven't been paying attention, Mackenzie Phillips, born to John Phillips of the Mamas and the Papas and socialite Susan Adams (one of John's many marriages), tells all in a memoir of her wild and crazy days behind the set of One Day at a Time.

For most of us, starring in a hit television show would be wild enough, but Mackenzie's drug addled, depraved father seduced her, made things even wilder for his daughter. He made her his lover and the affair lasted ten years. I've heard it several times,

I'll teach you how to love someone.

This is the family child molester's favorite line.

I haven't read the book, but Ms. Phillips was all of 17 at the beginning of the sexual relationship, so we can say he seduced her. Even if she was head over heels in love with her father, that she was a minor is reason enough to rule out informed consent. That alone makes the act criminal. Minors can't consent to sex, not legally.

The Mamas and the Papas. California Dreaming. I Saw Her Again. Be careful who you worship when it comes to rock stars.

Mackenzie confesses to cocaine and heroin addiction, and we know that under the influence informed consent isn't possible either.

But let's get real. This is incest, internationally taboo.

John Phillips isn't around to talk about it, so for all we know the book is a pack of lies. If I hadn't heard more than a few handfuls of these stories first hand, I might think so, too. Ultimately Mr. Phillips passed away a victim of his own vices, heart failure at 65, eight years ago. Gave Mckenzie some time to write a book.

Now the question is,

Is this a good thing, to write a memoir? Maybe it hurts innocent people.

And the answer is,

Maybe yes, maybe no.

I read that her sister Chynna wasn't thrilled when she heard about the publication of the book and that it came as a surprise, not that she doubted the veracity of her sister's work. Chynna uses one of my favorite phrases, These things affect other people to explain her feelings. She has kids. Mr. Phillips had grandchildren.

Publicizing secrets comes at a cost, usually. It has to hurt innocent people, airing the dirty family laundry. In family therapy we talk about this as a process, especially when it comes to exposing incest, and suggest discretion.

Timing is everything when telling the kids, especially. They want the people they love to be infallible, perfect. (Who wants a predator for a grandfather?) This is why these confessions are frequently limited to a best friend, a trusted clergyman, surely a therapist. Therapists generally will work up a plan, make it thoughtful, considerate of everyone.

It has to be hard to break it to youngsters when a previously trustworthy family member can't be trusted anymore. So we might suggest tabling the discussion until they can understand what it's all about, if at all possible. Of course, if your aunt writes a book, it's hard not to hear about it.

Some secrets can be toxic, is the truth, they hurt people who hold them in. We have to talk about what has happened to us in life. We have to talk to someone. And exposing them ultimately might protect others from making the same mistakes. Awareness of danger is a good thing. We can learn from others and we like the details. Those of us in this business are traumatized hearing them first hand, but for others, the juice quenches a certain prurient curiosity.

The US interview goes on to say that Mr. Phillips also did time in a penitentiary for dealing drugs, and one of his sons calls him things I won't publish.

Living perpetrators of sexual crimes can get better. No one has to stay a creep forever. We have them on their knees in therapy, some of us, have them beg forgiveness. That helps a lot.

Hopefully Mackenzie did some healing writing her book. We wish her well. Sister Chynna's apparently a popular vocalist (I'm not always up on this stuff). I'm going to check out her work, see if it will help me get over the thought that I won't be listening to the Mamas and the Papas anytime soon.

Thanks to all of you who commented below, who recommended songs, movies, books and websites about this topic. It's clear that many of you already know that when we talk about sexual abuse, we're talking emotional scars, social isolation, and psychological/physical reminders of this kind of "love".

The whole thing makes me, personally, want to avoid the 'zines, the expose's, the memoirs. I'll stick to chick lit, maybe.

therapydoc

Coming Home

Law and Order, Special Victims, if you haven't seen it, is a weekly television drama about people who commit murders and sex crimes. When it's about incest, there's usually a big twist at the end.

Rape is featured in many of the episodes, sometimes stranger rape, sometimes acquaintance rape. Incest happens to be a type of acquaintance rape.

A blogger (Isle Dance) wrote and asked me to write about a situation that involves children and young adults who have sex with the friends of their parents, swingers. Some might call this a gray area for sex crimes since the "adult" in "young adult" technically implies informed consent.

Swinging, when it is with children, or perhaps even with young adults, can pose the threat of psychological problems we associate with sexual boundary violations.

When I read the email I wrote back:

"Sure, sure, remind me to write about this. Shoot me another email in March. Remind me if you don't see something on Everyone Needs Therapy by March."

But I was thinking,

Not now. Too depressing. Must we go here? It's so gray outside, the days are so gloomy and cold. Who needs more depressing posts?

I'm telling myself,

Go with something happy, TherapyDoc, something funny. Tell them you cried watching Mama Mia, because it made you miss your daughter, that the tissues are still on the sofa, whereas most people couldn't get past the first scene and nobody, nobody you know admits to having cried along with Merrill Streep.

And besides, if you take this one on, TherapyDoc, this topic, it's likely you'll end up ranting and moralizing, and there is enough of this on the web. The voice is boring. It is your job to educate, not to lecture, and you'll get so much spam, especially if you use the word, swingers.

But anyway.

I won't wimp out entirely, although this isn't exactly what my blogging pal requested. We'll poke about a bit in this not-so-murky territory.

When incest (the ultimate sexual boundary violation) came to our attention in the mid-twentieth century,* authors of textbooks dubbed it pathognomic, something associated with very serious mental and behavioral psychopathology, the winner, hands down, of the gold, the silver, and brass Olympic medals for both the victim and the perpetrator.

The experts said: Keep them in therapy forever.

That we kept them in therapy for years speaks to the sensitivity we had about sex back then. Sex without boundaries or permission was considered a really bad thing, morally wrong, bad for people, pathogenic. It caused disorder. And that thinking generalized to other sex crimes, as well.

Then and now, mental health professionals think that boundary violations can hurt kids and adults, too, sometimes irreparably, to the degree that the human psyche does not always forget.

We may always grieve an unprotected invasion of personal space. It may affect the way we see ourselves, the world, and everyone in it. Every sexual crime is an invasion of personal head space, too, not just a body memory.

But we're a lot better at treating it now, thanks to war.

It so happens that even acquaintance rape, certainly stranger rape, can mess with your brain in the same way that combat messes with a soldier's brain. The diagnoses and treatment protocols can be the same, too.

Post-traumatic Stress Disorder (PTSD) is the primary disorder associated with sexual crimes like rape and molestation, even secondary trauma, the witnessing of events that are ego-dystonic, that make us extremely uncomfortable.

But if it weren't for war, the psychological treatment of sex crimes against women and men, might still be enigmatic.

We know what we're doing now when we treat rape because governmental agencies (hospitals) have had to find ways to treat the flashbacks and nightmares suffered by war veterans. Thus the funding for research, and an explosion of knowledge about PTSD as it manifests in the twentieth century.

The better treatment interventions, cognitive behavioral therapy, relationship therapies, are working. We don't need to keep people in therapy forever anymore, although surely, for many, long-term therapy is a great idea. It is a lifeline purchased on the cheap at your local community mental health center.

It is fascinating that rape victims and combat veterans share the same syndrome, but makes sense. Life is a battle field. Nobody's in Kansas anymore.

The real difference between then and now is that now we hear so much more about sex in general from the media. We hear about normal sex and about criminal sex, and your bread and butter sexual boundary violations, some perpetrated by teachers and clergy. We hear about it in newspapers and magazines, and we catch it on cable, let's talk, although it's obvious you can absorb quite a bit of chatter, see every sort of video on the Web.
Your average media gulping adult or child, sees a pervasive treatment of sex, one that acknowledges sex as a normal, healthy part of loving relationships, and as a dangerous, sometimes perverted element to crime. Sex is in our face any way we shake it.

As they say in the marketing business,

It sells.

Always did. But because it is so pervasive, because we're inundated with it, it is only an issue, a problem, if: (a) you can't find it; (b) you need to learn how to do it; (c) your partner is too tired or not interested; (d) you or your parents feel it might be sinful,

(e) Or you, as a mature adult, think your sexuality needs enhancement, which can be purchased in pill form, a pill that will sustain an erection long past any need or desire, as advertized on television. Thank heavens we don't have to see that on those commercials.

And sex is a problem if (f) someone takes you by force, obviously, or

(g) someone takes advantage of someone else's age or gullibility.

Only this one can be an iffy call, a question of informed consent. It's iffy because kids have consumed the notion that sexual behavior is so much a normal part of life that they never need to ask or question whether it is appropriate. It's always okay, sex.** Didn't you know?

Uh, oh. This is a rant.

It is so normal that nobody pays much attention to what we might call iffy relations.

An under-aged person, a child of fifteen, perhaps, has sex with an older person, technically statutory rape, but our fifteen-year old wanted it. Shouldn't that be okay?

Or maybe it is a young adult, a person almost of age, who gets very stoned and doesn't object, seemingly wants it, then wakes up and thinks, "Uh, oh. What the hell did I do?"

Or does object, but the objection is over-ruled.

No means No in any State of the United. When a person of any age, in any relationship, says no and is overcome by someone who thinks that no is really yes, it's rape. Believe it or not.

But what about when you're of age and you say yes and you're high? Is it rape then?

Well, yes, if you weren't in a state of mind to give informed consent and wouldn't have said yes, were it not for the Ecstacy or whatever designer drug it was that you or someone else added to your evening.

Do you see how iffy things can get?

Which leads us to Winter Break, which is almost over. Winter break, summer break, spring break, these are peak therapy times. Kids come home and they don't look so good.

And it is often about trauma. We can thank federal initiatives. College coeds now know the definition of all kinds of rape because of federal funding. Educators, some of whom are peer counselors, some teachers, some social workers or rape victim advocates, are running workshops on campus.

And sometimes this education triggers memories of experiences past.

Research (I've read, mountains of it) suggests that if you were violated as a younger person, that you will be violated again as an older person. Something about self-esteem and unresolved issues.

So people like me see young people, mostly college students, during winter break, kids who are remembering the iffy times, those one-night stands, the stoned sex they thought they wanted at the time. Some have new content to add to old.

It's a therapy for post-traumatic stress.

You know, I could easily have waited to post this one, but winter break is almost over. If you think you need it, get some therapy on campus if you're heading back to school.

And if you want a few more stories on the subject, read my post on innocence lost at TheSecondRoad.

Or check out Mama Mia. There is a subplot about the unintended, if not traumatic, consequences of unbounded sexuality, normal sex as we're defining it in the twenty-first century.

I'm telling you. The movie's not that bad!

therapydoc

*When I say "our" attention, I mean that generation of mental health professionals.

**Yes, I am being sarcastic, or would you prefer, facetious.

Reparations

In the comments to the previous post on Rocky Balboa we have the following dialogue:

Teebopop:

With regards to backtracking and fixing the errors of the past:

You can't change the past. Period. How is it possible to do that? What's done is done. There is no going back. You just have to deal with the past and hopefully learn from the mistakes. And even if I could fix things, would I want to? Would I be at the same place I'm at right now, good or bad, if I was able to fix things?

This totally confuses me.

TherapyDoc:

Teebopop, SOMETIMES you can change the present by referring to the past, especially if there is something to learn from something that has happened in the past. Clearly you can't change what has happened.

But you can apologize to people for the things you have done to them in the past and that changes the present and the future. Also, if you have been hurt by someone in the past you can go to that person and demand an apology and/or reparations.

What are reparations? I'll post on it right now. It's about time I did.

So the question is,
What are reparations?

Here's how it goes. A young woman comes to therapy because she's been sexually molested, perhaps even raped, by a member of her family many years ago. She was a young girl at the time and perhaps the perpetrator was only a few years older.

This isn't at all uncommon. Boys see their sisters and cousins as perfect objects of experimentation and need fulfillment. A girl is not always sure that what is happening is wrong or that it will come back to torment her in the future. Molestation can feel good and the girl has been sworn to secrecy, a perversion of emotional family intimacy. She also loves the perpetrator. He is her older brother/cousin.

At some point the molestation has ended, generally when he has found himself another girlfriend. The sister (let's say it's brother/sister incest) is confused and mortified. She knows, at some point in her emotional development that this wasn't the way it should have been. Incest is a universal taboo. There is no culture in the world that gives the nod to incest.

Years later she's in therapy. She's having difficulty with sex. She talks about the incest. We talk about bringing in her brother, making him own his part of her problem, and making him pay.

Thoughts of him, after all, have interrupted her life in the most egregious moments. She's bombed tests at school, she's panicked socially and on dates. She's never been able to finish college. She's felt guilty for having sexual desire, yet is unable to have romantic relationships.

We determine that an apology, him on his knees, literally, will feel very good, along with financial assistance so that she can go back to school. She has worked through much of her emotional trauma in therapy with me. But she needs to cap it off. She needs to see him grovel.

He is willing to do it. He comes to my office ready to take a beating. He's been waiting for this, has known that one day he would have to accept responsibility for what he has done.
He gets down on his knees. He bows to her, then looks up, tears in his eyes. He begs her forgiveness. He offers to help. They cry. They hug. It's amazing.

It's family therapy, friends. It's the real thing.

Oh, and the intervention is direct from Chloe Madanes, Jay Haley's wife. (He's one of the fathers of family therapy). I am sorry, I'm not sure of the name of the book I took the intervetion from but I want to say, Uncommon Therapies.

Much of the work that I do today is grounded in this kind of therapy. It is called strategic family therapy. Do you see why I get a little less than humble when I diss the training of other schools? It's not that other types of treatment are less powerful in general. They're just less powerful in specific situations, much less powerful. This is one of them.

Copyright 2007, TherapyDoc