Untold

Peter is unusually quiet at the start his session. He looks down at his hands, then gazes out the window. I resist the temptation to ask him what is going on and remain silent with him. The silence grows more comfortable, the connection between us palpable.

“I know I’m going to tell you today. That doesn’t seem like such a problem. I guess the question is why I’ve never told you before. It’s been almost three years since I started seeing you. I know you’ll ask why I didn’t tell you sooner. I’m asking that myself.” Pause. “The answer isn’t obvious to me. If I hear myself say it never seemed like such a big deal, that seems ridiculous, even to me. If I say it was too hard to talk about, too embarrassing, too uncomfortable, I just don’t think that’s it.”

My discomfort increases as Peter continues speaking, trying to imagine what he might not have revealed. He’s talked about his rigid, explosive father; his removed, distanced mother; his bullying older brothers. I like Peter. Shy, reserved, anxious Peter has done well in his life. He’s a sociology professor at a local university, is married to a warm, accomplished woman, and thinking about having children. He worries about his anxiety, his tendency towards depression and his discomfort with the competition in the academic world.       

“I was molested by my Catholic priest,” he blurts out. “By my confessor. It’s like a joke. I wonder who he was confessing to.”

I’m shocked. Not by the revelation, but just as he’d anticipated, by his not having told me long before.

“I’m so sorry, Peter,” I say, “So sorry that you had to endure that experience.”

“And wonder why I didn’t tell you before.”

“Yes, that’s true.”

“Obviously the case in Pennsylvania brought it all back up. Not that I’d forgotten about it. Just brought it back to the forefront.”

“Leaving you feeling how?”

“Sad. Depressed. Disgusted. Angry. You name it. The feelings all victims describe.”

“And how do you feel telling me now?”

“I don’t know. Kind of numb I guess. It’s not like I thought about it every time I was in session. Occasionally it would go through my mind and I’d say, no, this isn’t a good time.”

“And when you thought it wasn’t a good time, why did you think you thought that?”

He shrugs. “Other things seemed more pressing? I really don’t know.”

Suddenly a thought comes to me. “Have you ever told anyone?”

“I told my wife. Before we got married. I thought she should know…”

“Can you finish that sentence?”

“See, this is exactly the problem. Once I tell, it all becomes about my having been abused by my priest.”

“What all becomes about your having been abused by your priest?” I ask, confused.

“Everything. My shyness. My depression. My anxiety. It’s not! It’s not only him. He didn’t cause everything,” he says angrily.

“Of course not,” I reply. “Being sexually abused – however significant - was one of the events that affected your life, along with many other things.”

Peter stares at me. “Do you really mean that?”

“Yes, of course.” I pause. “I just had a thought. That priest had so much power over you as a child, perhaps it’s that you don’t want to give him the power to have made you the adult you are, you don’t want him to control your adult self.”  

Tears run down Peter’s cheeks. “That’s right. That’s exactly right. I could never put it into words, but that’s what it is. The bastard manipulated me as a child. I didn’t want him to matter anymore,” he says burying his face in his hands, sobbing.

“I don’t think you’re going to like what I say next, but the problem is, that by not speaking about him, you have unconsciously given him the power to continue to silence you, to continue to hide as if you’ve done something wrong  - which you haven’t.”

“No! That can’t be! Oh my God, you’re right. I’ve let the bastard continue to control me!”

“Well, you’re now unsilenced. You’ve spoken. You told me. We have a lot of work to do around this Peter – and I don’t mean that he’s the only factor influencing your life – but he has been a significant force and it’s time for you to speak.”

“I’m so sorry, so sorry I never told you.”

“You have nothing to apologize for. As I always say, you can only do what you can do and you’ve now spoken.”

#MeToo

“I’m trying to decide whether I should join the hashtag MeToo movement and tell my story. All these courageous women are coming forward. Why shouldn’t I? I mean, I don’t have the same story. There was no famous actor or congressman, but still, I have a story.”

You most definitely have I story, I think to myself, remembering when Amber first started working with me many years ago, an almost mute thirty-five year old who held herself rigidly together, staring blankly into space. It took her over a year to tell me her story of sexual abuse by both her father and brother.

“And, after all, my brother is a pretty hot-shot business executive,” she continues.

“Is it that you’re concerned your story isn’t …” I hesitate. “…news worthy enough?” I ask, puzzled.

She pauses. “Maybe.” She pauses again. “You think that’s kind of crazy, don’t you?”

“I don’t know about crazy, Amber, but it confuses me. It’s definitely up to you whether or not you tell your story. I’d just want us to consider the consequences of your telling or not telling.  But what’s your fantasy here, that you expose your abusers and no one really cares? Is your wish that it be front page news?”

“I hadn’t thought of that but it’s a good question.” She sits in silence. “I’ve never told anyone except for that feeble attempt to tell my mother who obviously didn’t want to hear it so I immediately backed off. And you, of course. But even that took me a long time. I have considered confronting my brother.  Not my father,” she continues. “That would be way too scary. But I haven’t even said anything to my brother. What am I scared of? Having them deny it? I guess. Not having anything to do with me? That would be no great loss. But now I’m thinking of telling the world that my father and brother took turns raping me while the other one watched. It’s disgusting. I can’t even say it without feeling nauseous. How could I imagine telling the world?”

Although I have some thoughts about what might be underlying Amber’s conflict, I stay silent, waiting to see what she’ll come up with herself.  

“I would love to expose them to the world. I want the world to know how these seemingly normal upper-middle class men – boy in my brother’s case – can be brutal rapists. I was only 11 for God’s sake. And it went on and on until I finally got up the nerve to say ‘no’. And what would people say? That I could have said ‘no’ sooner? That I could have told my mother? Or somebody. I’ve certainly told myself those things often enough.”

“You say that it feels scary to confront your father, but it sounds like you find it less scary to imagine exposing him to the world.”

“I suppose I do. It feels more anonymous, like he can’t get to me. Standing in the same room with him and confronting him, I don’t know what he’d do. Scream his head off at me, for sure. Smack me across the face? Very likely. Kill me? I don’t know. Maybe.”

Feeling my anxiety rise, I say, “Amber, I don’t know whether your fear that your father might kill you is your fear as a child or your adult fear, but if the adult you is truly afraid that your father might kill you, I can’t imagine that your exposing him publically would decrease that risk.”

Amber’s eyes widen. “Now you’re scaring me.”

“I’m sorry, but when I said I thought we should consider the consequences of your speaking out, I wasn’t thinking about your placing yourself in physical harm.”

“But how do I know whether my fear is coming from my child self or my adult self?”

“I don’t know. We definitely need to talk about it more. And I should ask you if you’ve ever known your father to physically taken revenge on anyone.”

“I know I told you that he beat up my first boyfriend. I guess he didn’t want the competition. And that he sometimes beat up gay guys in bars. I know he has guns, but I’ve never known him to use them. Used to say it was for our protection. That’s a joke.”   

“Let’s step back a minute. Let’s for a moment ignore the possibility of your father retaliating and look at what you’d feel about publically telling your story.”

“Scared.” Pause. “Victorious. Like I finally got them back.” Pause. “But then I wonder what everyone else would think of me. Especially my fiancé. I haven’t even had the nerve to tell him. I’m afraid he’ll think I’m garbage. Or that he’d treat my brother and father differently.” Pause. “When I hear myself say that I think I must be crazy. Why wouldn’t he treat them differently? And why do I care? You know, I think maybe I should work on telling the important people in my life before I decide if I’m going to come out publically.”

I smile. “Sounds like an excellent idea.”

Shame

“I love you,” Melanie says, looking downward.

Twenty-five year old Melanie has been my patient for two years, a lovely young woman struggling with anxiety and depression.  One of six children raised on a farm by parents who saw their offspring as laborers, rather than cherished beings, Melanie has come to rely on me as one of the few people who is consistently in her corner. Professing her love for me doesn’t take me by surprise.

“Thank you, Melanie,” I say, “that’s a lovely gift.”

“No,” she replies. “It’s much more complicated.”

I wait, unsure what she means.

“I said that to my last therapist,” she says hesitantly. “You know, I’ve talked to you about Dr. Hopkins. I saw him for a couple of years before you.”

I nod.

“But I never told you what happened, why I left.” She pauses. “We had an affair.”

I’m shocked. Not that I’ve never heard of therapists inappropriately crossing sexual boundaries, but I’m surprised Melanie never told me something of such significance.

“I’m so sorry, Melanie. How come you never told me before?”

“I was too ashamed.”

The victim blaming herself. Not unusual I think to myself. “Do you realize that Dr. Hopkins abused you?”

“No. It wasn’t like that,” she protests. “I told you, I loved him. And he loved me back. That was the most wonderful surprise of my life. Someone I so looked up to and admired actually loved me!”

“Melanie, how did your therapy with Dr. Hopkins end?”

“Well, for a while we saw each on the outside and I continued to have my regular therapy sessions. Dr. Hopkins was very clear that we couldn’t do anything sexual in the office, that we had to remain professional during our sessions.”

I am beyond furious at this so-called therapist, but hope that I am successful at concealing my feelings.

“But then Dr. Hopkins told me he didn’t think I needed therapy anymore. So I quit and just saw him on the outside.”

Still seething, I wonder if Dr. Hopkins thought his prowess as a lover had “cured” Melanie or whether he just found it too difficult to keeps his hands off her during their sessions.

“But then one day,” she continues, “he said that we couldn’t see each other anymore. He told me his wife was sick and that he felt too guilty being with me. I was devastated. I mean, I knew he was married. I knew it wasn’t like we’d be together forever and ever. But I loved him so much. And I thought he loved me. So how could he just walk away?”

“When you say you thought he loved you, are you now questioning that?”

Melanie starts to cry. “I was a fool. I know I was a fool. Did I really think a smart, educated man more than twice my age would be in love with me? He wanted my body. But I just wanted so much for him to love me, that I deluded myself into thinking he did. That’s what I’m ashamed of, being such a fool.”

“There’s an awful lot to deal with here, Melanie, and I’m sure we’ll return to this many times, but I want to come back to us before the session ends. So what did it mean to you to tell me you loved me? And what response did you hope for – or fear?”

“I’m not sure. I know I don’t want to sleep with you, but I do want you to love me. I guess I want to crawl into your lap and have you stroke my hair and tell me you love me, just as you’d tell your own daughter. Is that wrong?”

“No, Melanie, what you wish for can never be wrong. But acting on that wish is different. You wanted Dr. Hopkins to love you, which really meant you wanted him to care about you, to cherish you and to act in your best interest, not his. He did abuse you, Melanie. He took advantage of your need, of your vulnerability and crossed what should have been an unbreakable boundary. As for us, the wish to crawl into my lap and be my daughter is a more than understandable wish for someone who was so neglected as a child. But if I were to act on that wish I would not be acting in your best interest, because I would be giving you the false hope that you can go back to being a child and get from me what you couldn’t get from either of your parents.”

“That makes me sad.”

“I’m sure it does. Mourning what you never got and never can get, is always sad.”

Welcome Back

Annette smiles wanly when I open the waiting room door, walks slowly into my office, and lowers herself gently into her usual chair.

“Welcome back,” she says with little enthusiasm.

“Thank you,” I reply, surprised by Annette’s distance and reserve. Although this was the Annette who began therapy with me many years ago, our close enduring relationship had allowed her to deal with her childhood sexual abuse and to transform into a warm, open, engaged woman. Now forty-five, she worked as a para-legal and had a full, satisfying life. Although she never married, she had several long-term relationships and a network of close friends. She was usually especially glad to see me after my return from vacation, eager to catch me up on her life.

After a brief silence I ask, “What’s wrong, Annette?”

“I have some really bad news,” she says, her voice barely audible. “I have metastatic colon cancer.”

My eyes widen, tears immediately filling them. “Oh Annette,” I say. “I’m so, so sorry. When did you find out?” I was only gone two weeks I think to myself, aware that I feel guilty I wasn’t here for her.

“Just yesterday. I guess I’m still in shock. I wasn’t feeling well, had some bloating, discomfort. I wasn’t hungry which, as you know, is unusual for me. I thought maybe it was just my usual stomach stuff, but I went to my GI doctor. He examined me and suggested a colonoscopy and a CAT Scan. I was too happy about that. And then the diagnosis, cancer. They want to start chemo. I don’t know. I don’t know what my chances are and if I’m going to die anyway, I’d rather not prolong the agony.”

I’m overwhelmed by sadness, sad for this woman who fought so hard in her therapy to get through the pain of her past, only to now be forced to confront a dire illness and the possibility of death. My own losses flash in front of me as well, my husband to metastatic prostate cancer, numerous friends to pancreatic cancer, liver cancer, breast cancer. The list seems unending.

“I’m sorry, Annette,” I say. “I know I’m not being helpful to you.”

There again is her wan smile. “No, you are. I can see how much you’re affected by my news. That means a lot to me. I know you care for me. I know I’m not just one in a long line of patients.”

“We’ve worked together a time long, Annette. Of course I care about you. And I’ll help you through this however best I can.”

“Will you support whatever decision I make about whether or not to get chemo?”

“I will, but there’s a “but” to that statement. I want you to be sure you’ve explored all your options and know what the doctors think of your chances.”

“I am going to see an oncologist.”

“Good. I’m glad. And I also think you need to give yourself some time. You just found this out yesterday. It’s overwhelming. It’s overwhelming to me, it must be more than overwhelming for you.”

“You’re the first person I told.”

“You didn’t call any of your friends?” I ask, surprised.

“No. I knew I’d see you today. I was afraid if I told anyone I’d totally fall apart. I called in sick to work. I couldn’t bear telling everyone there and I didn’t know if I could fake it. They know I haven’t been feeling well.”

“Do you feel you can tell your friends now?”

“I don’t know. I’ll see.”

“Annette, does this feel like part of the abuse all over again? Like an unwanted, foreign thing invading your body?”

“Oh my God, I hadn’t thought of that! But it’s true. I mean I know it’s not the same thing, but it does kind of feel that way. How did you think of that?”

“I guess because today you’re more like the self I knew when we first started seeing each other – removed, defended, isolating. I know it could be shock, but for you I thought it might be more. And it’s not only the cancer itself, but all the tests you had to take and will continue to have to take. So we’ll need to be sure that your decision about treatment isn’t contaminated by your desire to avoid what might feel like more abuse.”

“You’re right. I wouldn’t want that bastard to destroy me in the end.”

“I wouldn’t want that either. Go see the oncologist, tell some of your friends and hopefully you’ll have  time to decide what to do.”

“See you Thursday.”

“See you Thursday,” I repeat, aware of the now increasing importance of time. 

Ten Sessions

“This is our ninth session,” says Penny, a petite, anxious 29 year old, adjusting the pillow behind her back as she settles into the chair across from me. 

“And that means…?” I ask.

“We only have one session after today.”

Startled, I ask, “Why is that?”

“That’s all the insurance company allows.”

“I’m confused, Penny. I thought I explained to you that I’m not on any insurance panels and that you decided to see me anyway.”

“For 10 sessions,” she says, squirming in her seat. “That’s what my husband said I could do because you were so highly recommended. He said I could see you for the same 10 sessions the insurance company allowed and if you were as good as they said you should be able to help me in the same amount of time.”

Thoughts swirl through my head: I’m not on insurance panels because I don’t believe therapy can work in 10 sessions; you were sexually abused by a brother-in-law as a child, have to force yourself to endure sex and want to be “cured” in 10 sessions; you’re a scared, passive woman with three small children at home and have no one in your life to talk to other than me; I wanted to see you at least twice a week and we compromised on once, but I’m not a miracle worker.

I settle on a far more mundane response. “How would you feel about us ending after ten sessions?”

“That’s what my husband said I could do.”

“I understand, but how do you feel?”

“I don’t want to. Talking about all that childhood stuff, I don’t know, it’s brought it all back up. Now I really can’t stand to have my husband touch me. He’s not happy about that either.”

“Have you told your husband how you feel?”

She shakes her head, morosely.

“Can you?”

“It won’t make any difference.”


Penny’s passivity is difficult for me, but I know that’s always been her way of being in the world, the obedient little girl who did what adults told her – including her brother-in-law – and now the obedient adult who follows her husband’s dictates. I’m in a bind. I don’t want to become another person who tells Penny what to do, but I also can’t help her if she doesn’t stay in treatment.  


“What are your options, Penny?”

“I guess I’ll just have to stop after next week.”

“You wouldn’t consider talking to your husband about what you want? After all, he must also want you to become more comfortable with sex,” I say, aware that I am coaching her.

“Do you think that’s possible?” she asks, more brightly.

“It would certainly be my hope, but I know we can’t accomplish that overnight.”

“Would you talk to him?” she asks, plaintively.

Oops, I think, I should have seen that coming. “Penny, why do you think my talking to your husband would have more weight than your talking to him?”

She shrugs. “I don’t know. It just would.”

“But maybe it's important for us to understand why you feel he'd listen to me more than to you.”

“I just know he would.”

“Let me ask this, how are you and I different?”

“What?” she says, giggling, “In every way. You’re smart, educated, a doctor. You know what you’re talking about. There’s nothing about us that’s the same.”

“It’s impressive how much you put yourself down, Penny, how little you think about yourself, how you so easily give up your power. If you think so little of you, I understand that it would be difficult to present what you want in a convincing manner to your husband or anyone else.”

“So you’ll talk to him?”

I groan inwardly. “Is the answer for me to talk to your husband or for you to feel better about yourself and to be able to stand up for what you want?”

“But we’re running out of time,” she says.

“You definitely have a point,” I say, glad to be able to support her statement. “It would be difficult for us to sufficiently help you feel better about yourself in one remaining session.”

“So you’ll talk to him?”

I remain reluctant to step into the role of the authority who might save the day – assuming, of course, that her husband would listen to me which is clearly uncertain.  Instead I say, “How about this idea, Penny? How about if you ask your husband to come in to a session with you and you can tell him how your feel and I can be here to support you?”

“What if he won’t come?”

“I guess we won’t know until you ask.”

Shamed

“I feel as though I’m getting worse!” Jason says desperately. “It’s getting so that I can barely get myself to class. All I want to do is stay in my room and play computer games.”

“I think that’s because we’ve just started talking about the abuse.”

“I hate that word. If I told my friends they’d say I was one lucky guy, that they only wish they could have been in my place.”

“But you haven’t told your friends, Jason,” I say gently. “You’ve never told anyone but me. Why is that?”

Jason drops his head. He’s a tall, gangly 20-year old. With his red hair, freckles, and dimples, he’s cute rather than handsome.

“You know why,” he mumbles.

“Yes,” I nod, “I do. You feel ashamed. And you feel ashamed of

feeling ashamed. You think you should be happy, thrilled even, that your high school algebra teacher picked you to initiate into sex. But that’s not what you feel. You feel ashamed. And it’s important that we understand why that feeling haunts you. Can you tell me what did happen, Jason? How it started? Where it took place? What it felt like for you?”

“You’re joking, right? You want me to tell you all the details!!”

I have to be careful. I don’t want Jason to experience me as yet another abuser. “I understand this is difficult for you. I think you’ll eventually feel less shame if you can speak about your experience, but you can do it in your own time, however feels least uncomfortable.”

“I’ll try,” Jason says, turning red. “It started as kind of a dare. Miss Johnson was young, for a teacher I mean. And she wasn’t bad looking either. My friends and I joked around, talking about who could get in her pants. It was just joking. But then we started to create scenarios about how we could actually do it. I don’t think any of us had been with a girl. Well, maybe one or two, but certainly not me. So I started to think up a plan. I actually was good in algebra, but I started to get not so good. I’d make mistakes on tests, ask simple questions in class. Eventually, I asked Miss Johnson if I could come after school one day, if she could tutor me, that maybe she could help me out. Oh God! I can’t stand hearing myself say this out loud! I planned the whole thing. It’s my fault!”

“You feel guilty, Jason, because what you supposedly wanted to happen, happened. Except that Miss Johnson was the adult and you were the child and it was her responsibility to maintain the limit.” I think of all the patients I have said this to over the years – patients abused by one or both parents, by various relatives, neighbors, clergy, teachers. The list goes on, but the child always ends up blaming him or herself. As painful as guilt may be, it is preferable to feeling powerless in the hands of demanding, capricious, insatiable adults who are supposed to be your caretakers.

I continue, “And it’s still a long way from a deceptive prank to a sexual encounter.”

“I went back a few times. And of course I improved since I knew all the stuff to begin with. Miss Johnson was so pleased that one day she asked if I’d like a soda as a reward. I told her I didn’t know how I’d get home ‘cause I had to catch the last bus. She said she’d drive me.”

Jason speech quickens, “So we had our soda and then she drove me, except she drove me to her house, and I couldn’t do anything and I felt horrible and she took me home and told me it would be all right. Then we did it again and I was hardly any better. And then she never asked me again and that was the end of it.”

“So not only did you feel it was your fault for wanting Miss Johnson, you felt inadequate because you weren’t a good enough lover.”

“I was shit! And she knew it!” Jason says.

Again, memories of previous patients of sexual abuse flood me. Just as guilt is invariably a part of the aftermath, so are feelings of inadequacy. I look surreptitiously at the clock. Only a few minutes left. I need to close this in a way that doesn’t leave Jason feeling intolerably raw.

“Jason, you’ve talked about a lot of hard stuff today and it’s almost time for us to end. What you’re feeling - the shame of not being good enough, of not being adequate. You have to remember that you were a child. Children aren’t supposed to be sexual. They’re supposed to be children. I know my saying this doesn’t automatically make you feel better but we’ll work on it. I promise.”