Whether delivered by hand grenade or by hurricane, by fist, machete, or burning plane, traumatic experiences are universal across cultures, and so are attempts to heal them. How well those attempts succeed depends in part on the stories a culture tells itself about victimizers and victimhood—about recovery, wholeness, and resilience. This is particularly true of intimate family violence, which broke into the light in the late 20th century, casting ripples that continue to this day.
As a systems therapist, incest survivor, and recovering alcoholic, I've lived through several stages of our culture's attempt to come to terms with child sexual abuse—as a victim in the silent 1950s; as a therapy client in the oblivious 1960s and 1970s; and as a psychotherapist in the 1980s and 1990s, when once-dismissed accounts of abuse filled my therapy practice (and my television screen) only to be partly discredited within the decade during another swing of the cultural pendulum.
We clinicians are still feeling our way toward a middle path, one that avoids the extremes of disempowering pity and "buck-up" denial. Our clients (and if we're survivors, we ourselves) still struggle to negotiate what sociologist Ervin Goffman called "spoiled identity": the isolating experience of being cast outside the circle of "normal" life, along with gays, paraplegics, and madwomen. Helping a client move from subjugation by the worst thing that ever happened to me to a nuanced and effective life has turned out to be more complex—and oddly enough, more commonplace—than I imagined when I first sought help.
One in a Million
The simplest version of my own story begins with my father. After he came home from World War II, he led at least three separate lives: one in Manhattan with his German mistress and her mother, who followed him to the States; one with my mother and me in Northampton, Massachusetts; and one in my bedroom at night, with my mother seemingly oblivious and asleep at the other end of our house.
The year was 1950, a time so different from the present as to be almost another country—a postwar, post-Holocaust world, cocooned in a vast cultural silence about victimization and the aftereffects of victimization. In this world, bleached of any reference to trauma, alcoholism, or child sexual abuse, there was no such thing as Megan's Law, Battered Child Syndrome, the Betty Ford Center, or Post-Traumatic Stress Disorder.
According to a leading psychiatric text, incest was something that happened only once in a million families. No child I knew ever told me she'd been repeatedly struck in the face (as I had) by a father who at other times was playful, loving, and kind. Until I was 17, I didn't try to tell anybody—not even my beloved godmother—that my father forced me to perform sexually. Nor before I was 24 did anyone believe me.
In 1962, as a frightened freshman at Cornell University, I made my way to the college counseling center. I was 17 and an excellent student, but I was already drinking heavily, sleeping around, and generally confused by my sexuality. In my initial interview, I wasn't explicit about my father's incestuous abuse. But I talked about my unhealthy closeness to him, my fear and loneliness, and my feelings of being "different" from others my age.
I began counseling with the head of the center. He asked me endless questions about my relationship with my mother. Although I kept trying to talk about my father, this man said it was because of my "overclose" mother-daughter attachment that I was experiencing the plague of bisexual attractions and recommended that I spend the summer with my father in his one-bedroom apartment in Manhattan. I fled from my would-be helper and waited seven years to try to speak again.
If this narrow story of trauma, rage, misdiagnosis, therapeutic mistreatment, and spoiled identity was all there were to tell, I'd be dead by now. But my life, like most lives, included commonplace and counterbalancing experiences that had nothing to do with abuse: the emotional support of my godmother and many teachers; a wordless enjoyment of the natural world; and successful involvements in school, radical politics, work, and athletics.
So it went until an early winter day in 1978, a year after my father's death, when I found myself in a car on an interstate in Connecticut, being driven back to my job (as a dorm counselor near my childhood home in Northampton, Massachusetts) by someone I hardly knew. After I opened the car door and tried to jump onto the freeway—it seemed like a good idea at the time—the terrified driver delivered me struggling and shouting to the emergency room of a hospital off the nearest exit.
Three days drunk, covered with blood from self-inflicted cuts, my hair disheveled, dressed in jeans and an old army shirt of my dad's, even my gender was unrecognizable. I was wrestled into submission by six emergency room workers, injected with a paralyzing amount of Thorazine, and transported by ambulance to a locked ward for violent women at the Connecticut state hospital in Waterbury. I was 34.
I sobered up in a gloomy, disinfectant-smelling darkness. Was I in a barracks, a dorm, or a concentration camp? I'd stayed briefly in private psychiatric hospitals before, but never had I been forcibly locked in with other violent, despairing women. Life had finally thrown in my face what a half-dozen therapists had overlooked. For a decade, my episodically competent days had been fueled by amphetamines, caffeine, rage, and prescribed antipsychotic drugs like Stelazine; in the evenings, I'd mellowed out with tranquilizers, gin, and sex with near-strangers. This regimen of prescribed and self-prescribed drugging had worsened my flashbacks until they mimicked transient psychotic states.
I don't know what diagnoses I'd been given by my well-intentioned New Haven psychologist, Dr. M., who'd minimized my alcoholism and repeatedly told me that my memories of incest were fantasies representing my disguised yearning for my father. But I suspect my bulging file contained references to borderline personality disorder or depression with psychotic features. Like thousands of other traumatically abused and misdiagnosed women, I was well on my way to developing the "spoiled identity" of a chronic mental patient. Dr. M. had led me to believe that I'd spend the rest of my life in and out of psychiatric units like the one I then found myself in at Waterbury.
Only my middle-class connections, I suspect, saved me from involuntary commitment. Two days after my arrival, three well-dressed, college-educated friends appeared in the middle of an ice storm and talked their way into meeting with the psychiatrist on call. "She needs to be in detox," said the psychiatrist, and released me to them.
It was the beginning of the end of my addictions.
Once I stopped abusing drugs and alcohol, my flashbacks and dissociated states lessened markedly. With my friends' encouragement, I weaned myself from the overpowering antipsychotic medications that had kept me groggy and debilitated. I'd given up the spoiled identity of the mental patient in favor of the more accurate—and therefore more helpful—label of the recovering addict and alcoholic.
The Politics of Truth
Clean and sober, I returned to graduate school and shot like a rocket from chronic PTSD and rampant addiction to what seemed like the other end of the rainbow. Within six years, I was "Dr. Miller," a clinical psychologist doing postdoctoral work in family and narrative therapy at the University of Calgary Medical School in Alberta. On one memorable day, I visited a Canadian mental hospital as a consultant and expert on domestic violence and addiction. I'll never forget a social worker's giving me an enormous key, which opened all the wards, including a locked ward similar to the one I'd been committed to in Connecticut.
As a family systems therapist, I loved drawing connections between a family's surface pain and hidden issues of addiction, patriarchal social assumptions, and domestic violence. I loved the "difficult" families, especially the mistrustful, mislabeled, and misunderstood mothers. I loved being mentored by iconoclastic family therapists who did battle with The System, personified by well-intentioned but oblivious social workers, psychologists, and psychiatrists like those who'd mislabeled and mistreated me.
Stories like mine were being whispered to a new generation of women therapists, spoken out loud in new 12-step meetings for adult children of alcoholics, and aired among feminists involved in the movement to stop domestic violence. The floodgates had opened. Control of the politics of truth had moved from the experts to the experienced.
After nearly a century in which the mental health field had dismissed reports like mine as fantasies, we victims lost patience with being spoken about and began to speak for ourselves. If our culture wanted to play Non-Protecting Bystander, we'd strip away the collective ignorance that had served as its shield. Like gay people and people of color before us, we defiantly embraced and began to dismantle the spoiled identity we'd been assigned. Oprah Winfrey, Maya Angelou, former U.S. Senator Paula Hawkins, and former Miss America Marilyn Van Derbur all said on television that they'd been sexually abused as children. By becoming vocal, we challenged the family and cultural role we'd been assigned: to suffer in silence, save everyone else from discomfort, and internalize the damage.
Nurturing the Competent Adult
In the classroom, in supervisions, and in my therapy office, I widened the lens and began analyzing precisely the outer (relational) skills and inner (self-calming) skills that trauma survivors needed to function better. Then I taught these skills, whether they were considered "therapy" or not. I began asking questions that were once outside the therapist's domain: How much do you exercise? What do you eat? Do you have a sense of a Higher Power or a Protective Presence in your life? How do you play and express yourself creatively? Do you meditate? Are you getting enough sleep?
In my own life, things were moving, too. I entered a long-term relationship with someone who helped me learn to play and have fun. We renovated a house together in Northampton with the help of our son-in-law, a contractor, and I became part of a family that included grown children and grandkids.
To date, I've trained more than 200 women with histories of trauma, most of them poor, with limited education. I call this program ATRIUM (Addiction and Trauma Recovery Integration Model) after the entry chamber of the heart. The metaphor is meant to suggest that the groups are just a starting point. Their graduates now lead similar groups in local prisons, jail diversion projects, AIDS programs, and the three drop-in centers for survivors. Many of these women—among them many welfare-dependent single mothers and grandmothers—have turned out to be more effective group leaders than some of the highly educated professionals that I've trained. They're helping create what may be the therapy of the 21st century: a blend of peer support, psychoeducation, interpersonal skills training, meditation, creative expression, spirituality, and community action.
Time Is a River
As a culture, we're only just waking from sleep. It's long been easier to blame people covertly for their reactions to childhood abuse than to face what happened to them. We pay staggering public health bills for the addicted and traumatized, but we balk at spending on preventing that trauma in the first place. Protective workers charged with investigating crimes against children, for example, make less than half what we pay the police officers who investigate adult crimes. Still, there are a few hopeful signs that this may change.
I think back 30 years to that desperate, unconscious, distrustful, and enraged young woman, three days drunk and covered with self-inflicted cuts, who was shot full of Thorazine and bundled off to a state hospital in Connecticut. She'd be both contemptuous and amazed to see who she's become: a physically healthy professional woman who works inside the system without ever quite joining it. And although I still hold in my heart that wild young woman and understand how she came to be, the river of life has flowed a long way since then, and she's now only part of me.
This blog is excerpted from "The End of Innocence," by Dusty Miller. The full version is available in the July/August 2003 issue, Beyond Victimhood: Psychotherapy Enters a New Era.
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