Tuesday, April 30, 2013


It is a removed, frightened, unsmiling Andrea who comes into my office, lowers herself slowly into the chair and looks furtively around my office, avoiding my eyes.   

“I can tell you’re still having a hard time, Andrea,” I say gently.

She nods. “I think my husband’s losing patience with me,” she says, barely above a whisper. “He doesn’t get it. And I suppose it doesn’t exactly make sense. The bombings in Boston have nothing to do with what happened to me. I wasn’t in a terrorist attack. I wasn’t in a war. I never almost lost my life.”

“I’m not sure, Andrea,” I interject. “You were in your own personal war zone. You never knew what would happen next, what your father might do. It’s easy to imagine that you might have felt, one false step and, who knows, maybe you’d be dead.”

“You really think so?” Andrea asks plaintively. 

Andrea and I have been through conversations like this many times over our years of working together. Sexually abused by her father from a young age, beaten for disobedience, locked in closets, I’ve been amazed that she’s been able to function as well as she has. She works as a paralegal, is married and actively involved with friends. Often she’s smiling and bright and engaged. But Boston has thrown her back into her personal trauma and it takes a while to help her dig her way back out.

Andrea’s plight is not unique. I remember after 9/11. At that time I was seeing Rachael, probably the most horrifically abused woman I had ever treated. She, too, had amazing strengths, but as the Twin Towers fell, it was as though Rachael fell with them. The world again became a horribly unsafe place where anything catastrophic could happen at any minute. She was back to being a powerless, defenseless child, who was literally afraid to leave her apartment. I haven’t seen Rachael for many years now. I wonder how she’s faring in this new national tragedy. But now there is Andrea.

“I told my husband I’m not sure I can do it, I’m not sure I can bring a child into this world. I’d never survive if anything happened to that child. Like I don’t know how that father is existing, the one whose eight-year old was killed when he ran out to greet him. How can you survive something like that? How don’t you hate yourself for the rest of your life?” Andrea says, her voice rising.

“I’m sure that father does feel guilty, Andrea, but you notice that you’re doing what you often do, blaming yourself, feeling guilty instead of feeling powerless and angry. You were the abused child, Andrea. There was nothing you did that made your father abuse you.”

Andrea sighs. “I know. You say that all the time. It’s hard for me to stay there. I always wonder what I could have done differently, how I might have been different. He didn’t abuse my sister!”

“As awful as guilt is, feeling scared and powerless often feels worse, more out-of-control,” I say, flashing on my own childhood experiences. Although I was certainly not abused like Andrea or Rachael, my father’s explosive rages were always terrifying for me. I never felt they were my fault; I never felt I could do anything to prevent them. And I remained terrified of his angry outbursts until he died, when I was already in my fifties. And although intense anger can still make me very uncomfortable, 9/11 and the Boston Marathon do not increase my general feelings of unsafety. I have just enough of my mother’s denial mechanisms to ward off the terror people like Rachael and Andrea experience. I’m fortunate.

I bring myself back to my patient. “I know it’s always been difficult for you to understand why he picked you for his victim, Andrea, rather than your sister. It’s something he did, for whatever reason. You were the younger. Was that the reason? Maybe you were cuter, smaller, smarter. It’s an unanswerable question. But regardless, it wasn’t your doing, it wasn’t your fault. And you bear the scars.”

Andrea seems to shrink back into the chair. She’s not really hearing me. “I’m sorry, Andrea,” I say. “I can see that this is way too much for right now. You just need to know that I’m here, that you’ll get through this. It may take a while, but we’ll get through it.”     

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