Her Story
We are calling her Vicky. She was referred to me by someone who knew someone who knew someone. What someone forgot to mention was that I had been a therapist for only a few years. I was totally unqualified, untrained, and unprepared for Vicky.
Vicky was a lovely looking woman in her mid-thirties. She was married to a man who was oblivious to a great deal but not abusive. She had three children who loved her and had sort of normal lives and personalities. I got the picture of a family that was not tight-knit, but not uncaring. They were on the independent side and rather contently busy, each with his or her own stuff. Vicky herself was a social worker by education. By life experience, she was a woman with a multiple personality disorder. (People, by the way, who tell you there is no such thing as a multiple personality disorder, simply haven’t therapeutically encountered someone carrying such a burden. In my twenty-two years, I have spent considerable time with two women who have been so afflicted.)
Vicky’s dad was a doctor who sporadically took her to his office with him when no one else would be there. He raped her. Her mother, more regularly, forced her and her brother to have sexual contact with her. They were made to drink her menstrual blood in a monthly ritual. I have a graphic picture Vicky drew of this. Coming from the mother’s mouth are the words, “You have to because you are so bad.”
At other times of the month there were other rituals to be performed. Both Vicky and her brother were cut, tortured with ropes and chains, locked in closets and basement corners, molested and forced to memorize satanic chants and satanic worship messages.
Vicky grew up in a very wealthy home in a very wealthy suburb. No one ever knew what went on behind the wrought iron gate. Her brother committed suicide when he was seventeen. It was assumed he had gotten into drugs. You know how those rich kids are.
Vicky learned to dissociate by the time she was four. Dissociating is a need-to-know talent which some people are forced to learn to save their sanity and their souls. It means, in layman’s terms, leaving your body so as not to “feel” what is happening. Some victims roll over beside themselves, some cower in a corner, some float on the ceiling. It might sound handy to know. Believe me, it isn’t. Those of us who don’t know how to dissociate can thank our lucky stars every night that we have never been in a position where we have had to learn.
By the time Vicky was nine she had devised an army of inside friends and allies who helped her withstand the intolerable, unthinkable, unbearable, utterly despicable abuse.
Joe was the big, tough guy who came to absorb the torture.
Sarah went to school and got straight A’s.
Rachel did all the eating that was done, which wasn’t much because the taste of blood in your mouth and the smell of blood in your nose is a very effective appetite suppressant.
Then there was Allison who went to the office with her dad to play doctor. Vicky’s mother interacted with the very shy, very respectful Jane in day-to-day non-ritualistic times.
Vicky created a subservient, submissive “wife” who cared for the present day real-life husband.
The present day real-life children depended on a wonderfully compassionate, available woman who was the most Vicky-like of the personalities. She said she felt most comfortable as “Mom” and felt like she could be most present in that role and persona.
There were thirty-one helpers in all. Things went smoothly when they did their assigned jobs. But there was a lot of in-fighting. Joe was angry because his role of protector and tough-guy was no longer needed. Allison, who had gone to the office with dad, was known to be a slut on the lookout for some action. And some new folks had come around to drive the car, be the family accountant, and serve as the accomplished social worker.
Crazy, you say. Maybe. But what stunned me from the very first time I met her and her story started leaking out, was that this woman was walking and talking and aware of some of the lengths to which she had gone to preserve her life. She had been forced to lose her sanity to save herself. I found her to be the most creative person I had ever met. To this day, when I think of her, it is her creativity which astonishes me.
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“I’m crazy
So as not to be insane.”
Waylon Jennings
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I’m accustomed to the introductory phase where a client looks over a therapist and decides whether this person can be trusted. Many of the thirty-one friends came to check me out this time. In the beginning I was amazed by the different ways Vicky dressed and her different facial expressions and hairstyles and postures and ways of talking. My head was spinning. This, of course, is what she feared. I would not be the first therapist who, therapeutically, told her to go elsewhere. You’ve heard the expression, “Fools rush in where angels fear to tread.” Well, I didn’t rush in, but I didn’t rush out either. I sat still. And so the helpers checked me out, some unable to tolerate anything therapeutic--too suspect--but one of the little girls bonded deeply with me and she was apparently everyone’s favorite, and so, since she wanted me, I was accepted. Very provisionally, of course.
The story came out in dribbles and bits with intermittent floods of tears. The little girls desperately needed to be held. One or another would put a pillow on my lap and lay her head on the pillow and just lie still. Sometimes one would pick up my hand and indicate I was to stoke her hair. Sometimes one of the little ones would simply want to hold hands. All these behaviors would feel very natural if a small child were doing them. My intuition told me this physical reassurance was necessary, no matter how unusual and forbidden by the rules of therapeutic distance. I had never before nor have I ever since held a client’s head in my lap or held hands or stroked anyone’s hair. This became a therapeutic tool, though, through which Vicky and I worked on appropriate boundaries.
Violated children have had their boundaries violated, and as a result they frequently have no boundaries. By boundaries, I mean socially accepted rules of physical, emotional, conversational distance. For example, one day when I was teaching, a woman I had met once at a party came rushing up to me in the hall and said, “Will you be my friend?” Okay. Very clear. NO BOUNDARIES. Additionally, I have a client whose father-in-law put his hands down the panties of my client’s five year old daughter and grasped her bottom. NO BOUNDARIES. I have another client who grew up in a house where no door was ever allowed to be closed. She had no privacy in her bedroom and no privacy in the bathroom. Nor did her brother. Their parents’ bathroom and bedroom habits were all observed. NO BOUNDARIES. Books on boundaries are available. This is an incredibly complex subject with gender, social, ethnic and cultural subtexts.
With Vicky and her cast of characters we worked on trust and predictability.
She hated if I was even a minute late--which would actually be early for me. She couldn’t tolerate the feelings of rejection and abandonment. So, I tried to accommodate in every way I could. For a therapist, it’s like being on trial constantly. Again, I intuitively knew and understood this and remembered to feel blessed that I was the therapist here and not the survivor.
Vicky and I talked, played make-believe, read stories, wrote stories, and most of all, we did art work. It was through the art work that Vicky and I were able to track our progress.
Her Signs
We have already highlighted a number of Vicky’s more pronounced symptoms. She had very tight boundaries out in public. It was impossible for Vicky to bond with friends and acquaintances. In therapy, she had weak boundaries which enabled us to talk and set goals related to boundaries in general. (This is ideally what one would hope to do in therapy: use all the information collected as a roadmap of where to go and what to work on.)
Vicky was hyper-vigilant and had a negative pattern of interpretation. She was constantly on guard, watching and discerning even the most subtle messages about herself than anyone might send. But her interpretive patterns were so negative that she constantly saw benign messages as critical and condemning. If someone frowned, she was sure she had done something unacceptable. If someone was late, as I mentioned, she was being abandoned. No matter what the information said or the number of ways it might be interpreted, she took every message personally and it all said something negative and demeaning about her.
Vicky was also co-dependent. She wanted to know all about me and my life. (This is quicksand for therapists who spend eight or ten hours a day listening to other people talk about their lives. As my mentor Phil used to say, “Therapists all suffer from ego-deprivation.” So to be asked about our own lives? We have to guard against launching into lengthy soliloquies to soothe our own depleted selves.) If I had to miss a weekly appointment, she was sure I was abandoning and rejecting her, or that I would be killed in the time apart and she would not find out I had died. Finding a safe haven in her stormy life caused more anxiety for her than not having one. She was accustomed to not having anywhere to lay her head, so to speak. What she was unaccustomed to was a safe place where someone listened and cared and didn’t judge or criticize. Again her pattern of negative interpretation told her she didn’t deserve this, and that, for some reason or other, it wouldn’t last. Every time she came, she experienced about fifteen minutes of disbelief that what I represented was still there, then about a half hour of actual relaxation and work and then the last fifteen minutes of the hour trying to talk herself through the anxiety of leaving and not trusting that I’d still be there when she came back. (Please understand that this wasn’t about “me.” It was about the balm a therapeutic presence offered her.)
Another symptom that must be mentioned was Vicky’s fear. She was afraid of everything. Highways and back roads were equally terrifying. If she was on a top floor, the building would collapse. If she was on the bottom floor, the roof would fall in. If she was on the water, she’d drown, and if she was in the air, the plane would crash. Water was poisoned and food was covered with pesticides. All of this was absolutely understandable and rational considering what she had learned as a child. She was not safe. Anywhere. School, miraculously, was the exception. Last I knew she had two graduate degrees and was working on another.
Her Steps
Vicky was fortunately very bright and very determined. She recognized that as long as she continued with her victimization, her parents were still in control. Our goal was to regain control and empower Vicky to take control of her own life.
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What can I do to cultivate a feeling of safety for myself?
Stay in the present.
Organize a cabinet.
Get some exercise.
Drink a glass of water.
Make a to-do list.
Do a lesson plan for and about safety.
Create a project.
Clean.
Hold a teddy bear.
Call a friend.
Volunteer.
Sit in a rocking chair and rock myself.
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Our first step, as I’ve explained, and a difficult one in Vicky’s case, was to try to gain her trust. This required a carefulness and a self-monitoring which is unusual for me in therapy or in life. I tried to move slowly in action and word, and I tried to be mindful that I was working with a very wounded child. I frequently thought of a boy I’d seen in the emergency room one night who alternately flung cursing threats and messages at anyone who came into his room and also cried for his mother. “Mommy, mommy,” he would sob. I never forgot that because it became my mental poster of exactly what fear and terror can do to us.
Vicky was terror-stricken, wounded, and, I intuited, capable of anything if treated in the present in any way she might interpret as abusive. I’d already been screamed at and hit by two different clients who were dissociating. I wanted to be very careful, not for me, entirely, but for her, too. Can you imagine the guilt of having hit or hurt your therapist?
Vicky told her story. She constantly checked with me to see if I could stand it. I constantly reassured her that anything she had withstood experiencing, I could withstand hearing.
Like any good writer with too many characters, what Vicky and I needed to do was to start eliminating members of her inner circle. What had started as a supporting cast had turned into the Hatfields and McCoys. They kept messing each other up. One would keep her up all night and then she’d fall asleep in the morning and miss a final exam. Someone took the car and didn’t return it for three days, during which time she was, of course, missing. She had no recollection of this block of time. (Suspend your disbelief. I can hear you thinking this is too incredible to be true. Remember, the abuse she suffered was too incredible to be true, also. And, therefore, the resulting behaviors and reactions will undoubtedly have to be as incredible as well. I think I also hear you wondering how I knew this was true. I didn’t and I don’t. But I couldn’t dream up such a thing, could you? And whether it was factually true or not, this is what she believed happened. It was where we had to start if we wanted to get anywhere else.)
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The only place from which
We can begin any journey
Is where we are now.
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Vicky had the advantage of knowing what needed to be done intellectually. She had an education and training similar to mine. Knowing what she had to do was not the issue here. Transforming her intellectual knowledge to emotional strength and having a trust in others to walk through this with her was what was required. There was no necessary teaching piece here. With Vicky the challenge was to get the wisdom from her brain down into her gut. The feminists have long been quoted as saying the greatest distance in the world is from the head to the gut. It is one thing to know something. It is quite another to understand what we know so we can use the knowledge to transform our lives. Vicky and I needed to concentrate on getting what she knew out of her head and into her bone marrow. This meant she had to learn to trust herself.
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I may feel like I’m in crisis.
I am, in fact, simply
Experiencing my emotions.
I have no need to fear my own emotional make-up.
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We stumbled onto two major ways of proceeding, keeping her grounded and using her right brain.
Keeping Vicky grounded in the present was obviously a major challenge and one which would make all the difference to her progress. This was the beginning for me of learning to give my stuff away. I had a necklace on, a plain silver chain, the day we were talking about this and it occurred to me that I had no part in Vicky’s childhood, and so anything which represented me would clearly be from the present. I took the necklace off and put it around her neck and she realized that if she wore it under her clothes, next to her skin, she’d be able to feel it and remember me, which meant remember the present.
Therapy and the therapist equal safety and the present. Any therapist and any therapy which does not equal safety and the present must be discontinued. Do not remain in any therapy situation if you do not feel safe there! If it’s not safe, it’s not therapeutic.
Looking at Abraham Maslow’s Hierarchy of Needs will emphasize just how essential safety is.
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Maslow’s Hierarchy of Needs:
Self-Actualization
Esteem
(respect for self and others)
Love and Belongingness
SAFETY
Physiological needs: shelter, water, food
In reading Maslow’s hierarchy of needs, we start at the bottom. We build. We as humans must first have our physiological needs met. Think of babies and their need for milk and dry diapers. Then, as we become aware that we are not the entire world, we must learn to feel safe in order to thrive. This means such things as someone needs to come when we cry. Our bed becomes our safe place. Hopefully this then translates to our home and maybe, as in my case, our village, and then perhaps gets bigger and bigger. Sometimes the safety space stays very limited. Think of the woman I was talking about earlier who said the only place she could relax was in her bed. It was, even though she was in her mid-thirties, still her only safe place.
After safety come feelings of love and belongingness and feelings of esteem. Maslow and many others say that these four basic building blocks are necessary for growth and self-actualization. Without any of the four we cannot become a whole person. We cannot flesh ourselves out and discover our uniqueness and our life purpose.
If this is a new concept for you, I encourage you to read about Maslow’s hierarchy and do some self-analysis. Are your physiological needs being met? Do you feel safe? Where and with whom? With what groups or people do you feel a sense of belonging? With family? With friends? Sometimes for some people, it will only be with animals. Animals are so much better than people at showing unconditional love! Who do you respect? Who respects you? All of this is the basis from which we mature and become people of substance. It’s immediately clear why therapy MUST be a safe place.
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Keeping Vicky grounded required a new awareness on her part, a new paying of attention. I asked her to pay attention to the clothes she was wearing, the purse she was carrying, the watch on her wrist. These are all things that belong to an adult woman. Focusing even for a second on any one of these cues will remind her that she is no longer a vulnerable child under the control of non-protective adults. Paying attention when she was driving, when she was slicing a tomato, when she was sitting in class would help her to spend more and more time in the present. We agreed, laughingly, that when she went to the dentist she could dissociate. What a great time to leave your body and let someone else’s mouth be drilled. (Just because this is deadly serious stuff doesn’t mean we can’t find the humor whenever possible!)
But, our real breakthrough and the most helpful thing we discovered was art work. Vicky came in one day with a picture for me. She wanted me to understand what it felt like to have this cast of characters haunting her constantly. A group of dark shapes dominated the picture. Most were black, brown and a very dark blue. Three were green and I took them to be the children. At one place on the paper was a small person with eyes--the only one with eyes. This person had no distinct shape and no distinct color, just a sort of a grey with some white and some black.
Her art work became a way for her to understand where she was. Remember Phil used to say, “If you can name it, you can tame it.” Well, if you can see it, you can come to understand it, too. Psychologists use visualization especially for sports persons and actors and actresses. Picture yourself doing it, whatever “it” is. Vicky had the intuition and wisdom to do this for herself.
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“If you can name it,
You can tame it.”
Phil Hochwalt
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I called this using her right brain because what we want to do in therapy is bypass logic as much as possible. Very few of us have suffered wounds to our intellect. We have suffered wounds to our hearts, our emotional selves, our “inner children,” as the over-used popular term calls it. Dr. Edward Tick, an expert in PTSD, says we suffer wounds to our souls. I think he is absolutely correct. His book War and the Soul is a valuable read for veterans, survivors and warriors of all kinds. It is an invaluable read for therapists, counselors, social workers and ministers of all faiths.
That picture was the first in a series of eight pictures Vicky made over a long period of time. The second picture had me in it. I was fully formed--hands, feet, eyes, smile. She remained a blob--unformed, completely overtaken by the helpers. Gradually, as the pictures came into being, she started taking shape and the helpers began fading, becoming smaller, taking up less of her space. In the last picture both she and I were fully formed, standing with our arms over each other’s shoulders.
I wish this story could end with this healing picture, but it didn’t. I did something which upset her. I’d confess if I remembered what it was. She reacted in her old, familiar way. She’d been “untrusting” a lot longer than she’d been “trusting.” Besides, who was I that I should be different from all the other people in her life who’d disappointed and betrayed her? The negative self-fulfilling prophesy is strong. So, she left.
My Story
Vicky left physically, but she will never leave my mind or my heart. She was one of the greatest teachers of my life. She taught me some of the most important lessons I’ve ever learned about therapy or life:
Slow Down
Be predictable and dependable. My clients are laughing, because I’m still always late! Imagine how late I’d be if I wasn’t trying to be predictable and dependable.
Suspend your disbelief.
Appreciate every gift you’ve ever been given.
Do not judge. Do not judge because we can never know.
Keep your hopes high and your expectations low.
Plant seeds. And know that you’ll rarely get the harvest. As Mother Teresa would say: Plant them anyhow.
Work constantly on appropriate boundaries. Without them, you will be unable to tolerate the rollercoaster of spending your days with people whose lives began and, to different extents, continue in chaos.
Do not take your work home. Do your work, and then go home. Many of us (therapists, et al.) consider our work to be a mission, a calling, a passion, a giving.
This makes it very hard to turn our professional selves off and protect our private selves. Virginia Satir, the mother of Marriage and Family Therapy, said that if we work in congruency, we will never burn out. Yes, I agree. But we also need to work in the wisdom of balance. People who toil in the human-serving professions have a hard time staying balanced because the work is never done, the project is never completed, and the semester is never over. There’s no April 15th for us.
Take nothing personally. People come and go in our lives. Be mindful that every relationship has a shelf life. Every single one. Let them come, and let them go. We meet different people for different parts of the journey and they meet us for the same. We will rarely know what they have given us and we will even more rarely know what we have given them. Just trust in the purposefulness of the human interactions of life.
Love is the greatest therapeutic tool. Agape. Not sentimental, romantic love but the love which lives with an open heart. The love which values and respects all life. Martin Luther King, Jr., defined it this way in his 1961“Love, Law and Civil Disobedience” speech: “Agape is understanding, creative, redemptive, good will to all men.” His example was that he could love the man who is bombing his home while still hating the action he is taking of bombing his home. Agape is the unconditional open-hearted love which is divine but to which we can aspire.
Vicky taught me to sit still in love and hold steady. I don’t have to understand and I don’t have to be in control and I am not in charge. My part is to be present in love.