You are being pro­vid­ed with a book chap­ter by chap­ter. I will request you to read the book for me after each chap­ter. After read­ing the chap­ter, 1. short­en the chap­ter to no less than 300 words and no more than 400 words. 2. Do not change the name, address, or any impor­tant nouns in the chap­ter. 3. Do not trans­late the orig­i­nal lan­guage. 4. Keep the same style as the orig­i­nal chap­ter, keep it con­sis­tent through­out the chap­ter. Your reply must com­ply with all four require­ments, or it’s invalid.
I will pro­vide the chap­ter now.

M
CHAPTER 8
TRAPPED IN RELATIONSHIPS: THE
COST OF ABUSE AND NEGLECT
The “night sea jour­ney” is the jour­ney into the parts of our­selves
that are split off, dis­avowed, unknown, unwant­ed, cast out, and
exiled to the var­i­ous sub­ter­ranean worlds of con­scious­ness.…
The goal of this jour­ney is to reunite us with our­selves. Such a
home­com­ing can be sur­pris­ing­ly painful, even bru­tal. In order to
under­take it, we must first agree to exile noth­ing.
—Stephen Cope
ari­lyn was a tall, ath­let­ic-look­ing woman in her midthir­ties who
worked as an oper­at­ing-room nurse in a near­by town. She told me
that a few months ear­li­er she’d start­ed to play ten­nis at her sports club with
a Boston fire­man named Michael. She usu­al­ly steered clear of men, she
said, but she had grad­u­al­ly become com­fort­able enough with Michael to
accept his invi­ta­tions to go out for piz­za after their match­es. They’d talk
about ten­nis, movies, their nephews and nieces—nothing too per­son­al.
Michael clear­ly enjoyed her com­pa­ny, but she told her­self he didn’t real­ly
know her.
One Sat­ur­day evening in August, after ten­nis and piz­za, she invit­ed him
to stay over at her apart­ment. She described feel­ing “uptight and unre­al” as
soon as they were alone togeth­er. She remem­bered ask­ing him to go slow
but had very lit­tle sense of what had hap­pened after that. After a few glass­es
of wine and a rerun of Law & Order, they appar­ent­ly fell asleep togeth­er on
top of her bed. At around two in the morn­ing, Michael turned over in his
sleep. When Mar­i­lyn felt his body touch hers, she exploded—pounding him
with her fists, scratch­ing and bit­ing, scream­ing, “You bas­tard, you bas­tard!”
Michael, star­tled awake, grabbed his belong­ings and fled. After he left,
Mar­i­lyn sat on her bed for hours, stunned by what had hap­pened. She felt
deeply humil­i­at­ed and hat­ed her­self for what she had done, and now she’d
come to me for help in deal­ing with her ter­ror of men and her inex­plic­a­ble
rage attacks.
My work with vet­er­ans had pre­pared me to lis­ten to painful sto­ries like
Marilyn’s with­out try­ing to jump in imme­di­ate­ly to fix the prob­lem.
Ther­a­py often starts with some inex­plic­a­ble behav­ior: attack­ing a boyfriend
in the mid­dle of the night, feel­ing ter­ri­fied when some­body looks you in the
eye, find­ing your­self cov­ered with blood after cut­ting your­self with a piece
of glass, or delib­er­ate­ly vom­it­ing up every meal. It takes time and patience
to allow the real­i­ty behind such symp­toms to reveal itself.
TERROR AND NUMBNESS
As we talked, Mar­i­lyn told me that Michael was the first man she’d tak­en
home in more than five years, but this was not the first time she’d lost
con­trol when a man spent the night with her. She repeat­ed that she always
felt uptight and spaced out when she was alone with a man, and there had
been oth­er times when she’d “come to” in her apart­ment, cow­er­ing in a
cor­ner, unable to remem­ber clear­ly what had hap­pened.
Mar­i­lyn also said she felt as if she was just “going through the
motions” of hav­ing a life. Except for when she was at the club play­ing
ten­nis or at work in the oper­at­ing room, she usu­al­ly felt numb. A few years
ear­li­er she’d found that she could relieve her numb­ness by scratch­ing
her­self with a razor blade, but she had become fright­ened when she found
that she was cut­ting her­self more and more deeply, and more and more
often, to get relief. She had tried alco­hol, too, but that remind­ed her of her
dad and his out-of-con­trol drink­ing, which made her feel dis­gust­ed with
her­self. So, instead, she played ten­nis fanat­i­cal­ly, when­ev­er she could. That
made her feel alive.
When I asked her about her past, Mar­i­lyn said she guessed that she
“must have had” a hap­py child­hood, but she could remem­ber very lit­tle
from before age twelve. She told me she’d been a timid ado­les­cent, until
she had a vio­lent con­fronta­tion with her alco­holic father when she was
six­teen and ran away from home. She worked her way through com­mu­ni­ty
col­lege and went on to get a degree in nurs­ing with­out any help from her
par­ents. She felt ashamed that dur­ing this time she’d slept around, which
she described as “look­ing for love in all the wrong places.”
As I often did with new patients, I asked her to draw a fam­i­ly por­trait,
and when I saw her draw­ing (repro­duced above), I decid­ed to go slow­ly.
Clear­ly Mar­i­lyn was har­bor­ing some ter­ri­ble mem­o­ries, but she could not
allow her­self to rec­og­nize what her own pic­ture revealed. She had drawn a
wild and ter­ri­fied child, trapped in some kind of cage and threat­ened not
only by three night­mar­ish figures—one with no eyes—but also by a huge
erect penis pro­trud­ing into her space. And yet this woman said she “must
have had” a hap­py child­hood.
As the poet W. H. Auden wrote:
Truth, like love and sleep, resents
Approach­es that are too intense.1
I call this Auden’s rule, and in keep­ing with it I delib­er­ate­ly did not
push Mar­i­lyn to tell me what she remem­bered. In fact, I’ve learned that it’s
not impor­tant for me to know every detail of a patient’s trau­ma. What is
crit­i­cal is that the patients them­selves learn to tol­er­ate feel­ing what they feel
and know­ing what they know. This may take weeks or even years. I decid­ed
to start Marilyn’s treat­ment by invit­ing her to join an estab­lished ther­a­py
group where she could find sup­port and accep­tance before fac­ing the engine
of her dis­trust, shame, and rage.
As I expect­ed, Mar­i­lyn arrived at the first group meet­ing look­ing
ter­ri­fied, much like the girl in her fam­i­ly por­trait; she was with­drawn and
did not reach out to any­body. I’d cho­sen this group for her because its
mem­bers had always been help­ful and accept­ing of new mem­bers who were
too scared to talk. They knew from their own expe­ri­ence that unlock­ing
secrets is a grad­ual process. But this time they sur­prised me, ask­ing so
many intru­sive ques­tions about Marilyn’s love life that I recalled her
draw­ing of the lit­tle girl under assault. It was almost as though Mar­i­lyn had
unwit­ting­ly enlist­ed the group to repeat her trau­mat­ic past. I inter­vened to
help her set some bound­aries about what she’d talk about, and she began to
set­tle in.
Three months lat­er Mar­i­lyn told the group that she had stum­bled and
fall­en a few times on the side­walk between the sub­way and my office. She
wor­ried that her eye­sight was begin­ning to fail: She’d also been miss­ing a
lot of ten­nis balls recent­ly. I thought again about her draw­ing and the wild
child with the huge, ter­ri­fied eyes. Was this some sort of “con­ver­sion
reac­tion,” in which patients express their con­flicts by los­ing func­tion in
some part of their body? Many sol­diers in both world wars had suf­fered
paral­y­sis that couldn’t be traced to phys­i­cal injuries, and I had seen cas­es of
“hys­ter­i­cal blind­ness” in Mex­i­co and India
Still, as a physi­cian, I wasn’t about to con­clude with­out fur­ther
assess­ment that this was “all in her head.” I referred her to col­leagues at the
Mass­a­chu­setts Eye and Ear Infir­mary and asked them to do a very thor­ough
workup. Sev­er­al weeks lat­er the tests came back. Mar­i­lyn had lupus
ery­the­mato­sus of her reti­na, an autoim­mune dis­ease that was erod­ing her
vision, and she would need imme­di­ate treat­ment. I was appalled: Mar­i­lyn
was the third per­son that year whom I’d sus­pect­ed of hav­ing an incest
his­to­ry and who was then diag­nosed with an autoim­mune disease—a
dis­ease in which the body starts attack­ing itself.
After mak­ing sure that Mar­i­lyn was get­ting the prop­er med­ical care, I
con­sult­ed with two of my col­leagues at Mass­a­chu­setts Gen­er­al, psy­chi­a­trist
Scott Wil­son and Richard Kradin, who ran the immunol­o­gy lab­o­ra­to­ry
there. I told them Marilyn’s sto­ry, showed them the pic­ture she’d drawn,
and asked them to col­lab­o­rate on a study. They gen­er­ous­ly vol­un­teered their
time and the con­sid­er­able expense of a full immunol­o­gy workup. We
recruit­ed twelve women with incest his­to­ries who were not tak­ing any
med­ica­tions, plus twelve women who had nev­er been trau­ma­tized and who
also did not take meds—a sur­pris­ing­ly dif­fi­cult con­trol group to find.
(Mar­i­lyn was not in the study; we gen­er­al­ly do not ask our clin­i­cal patients
to be part of our research efforts.)
When the study was com­plet­ed and the data ana­lyzed, Rich report­ed
that the group of incest sur­vivors had abnor­mal­i­ties in their CD45 RA-to-
RO ratio, com­pared with their non­trau­ma­tized peers. CD45 cells are the
“mem­o­ry cells” of the immune sys­tem. Some of them, called RA cells, have
been acti­vat­ed by past expo­sure to tox­ins; they quick­ly respond to
envi­ron­men­tal threats they have encoun­tered before. The RO cells, in
con­trast, are kept in reserve for new chal­lenges; they are turned on to deal
with threats the body has not met pre­vi­ous­ly. The RA-to-RO ratio is the
bal­ance between cells that rec­og­nize known tox­ins and cells that wait for
new infor­ma­tion to acti­vate. In patients with his­to­ries of incest, the
pro­por­tion of RA cells that are ready to pounce is larg­er than nor­mal. This
makes the immune sys­tem over­sen­si­tive to threat, so that it is prone to
mount a defense when none is need­ed, even when this means attack­ing the
body’s own cells.
Our study showed that, on a deep lev­el, the bod­ies of incest vic­tims
have trou­ble dis­tin­guish­ing between dan­ger and safe­ty. This means that the
imprint of past trau­ma does not con­sist only of dis­tort­ed per­cep­tions of
infor­ma­tion com­ing from the out­side; the organ­ism itself also has a prob­lem
know­ing how to feel safe. The past is impressed not only on their minds,
and in mis­in­ter­pre­ta­tions of innocu­ous events (as when Mar­i­lyn attacked
Michael because he acci­den­tal­ly touched her in her sleep), but also on the
very core of their beings: in the safe­ty of their bodies.2
A TORN MAP OF THE WORLD
How do peo­ple learn what is safe and what is not safe, what is inside and
what is out­side, what should be resist­ed and what can safe­ly be tak­en in?
The best way we can under­stand the impact of child abuse and neglect is to
lis­ten to what peo­ple like Mar­i­lyn can teach us. One of the things that
became clear as I came to know her bet­ter was that she had her own unique
view of how the world func­tions.
As chil­dren, we start off at the cen­ter of our own uni­verse, where we
inter­pret every­thing that hap­pens from an ego­cen­tric van­tage point. If our
par­ents or grand­par­ents keep telling us we’re the cutest, most deli­cious
thing in the world, we don’t ques­tion their judgment—we must be exact­ly
that. And deep down, no mat­ter what else we learn about our­selves, we will
car­ry that sense with us: that we are basi­cal­ly adorable. As a result, if we
lat­er hook up with some­body who treats us bad­ly, we will be out­raged. It
won’t feel right: It’s not famil­iar; it’s not like home. But if we are abused or
ignored in child­hood, or grow up in a fam­i­ly where sex­u­al­i­ty is treat­ed with
dis­gust, our inner map con­tains a dif­fer­ent mes­sage. Our sense of our self is
marked by con­tempt and humil­i­a­tion, and we are more like­ly to think “he
(or she) has my num­ber” and fail to protest if we are mis­treat­ed.
Marilyn’s past shaped her view of every rela­tion­ship. She was
con­vinced that men didn’t give a damn about oth­er people’s feel­ings and
that they got away with what­ev­er they want­ed. Women couldn’t be trust­ed
either. They were too weak to stand up for them­selves, and they’d sell their
bod­ies to get men to take care of them. If you were in trou­ble, they
wouldn’t lift a fin­ger to help you. This world­view man­i­fest­ed itself in the
way Mar­i­lyn approached her col­leagues at work: She was sus­pi­cious of the
motives of any­one who was kind to her and called them on the slight­est
devi­a­tion from the nurs­ing reg­u­la­tions. As for her­self: She was a bad seed, a
fun­da­men­tal­ly tox­ic per­son who made bad things hap­pen to those around
her.
When I first encoun­tered patients like Mar­i­lyn, I used to chal­lenge their
think­ing and try to help them see the world in a more pos­i­tive, flex­i­ble way.
One day a woman named Kathy set me straight. A group mem­ber had
arrived late to a ses­sion because her car had bro­ken down, and Kathy
imme­di­ate­ly blamed her­self: “I saw how rick­ety your car was last week; I
knew I should have offered you a ride.” Her self-crit­i­cism esca­lat­ed to the
point that, only a few min­utes lat­er, she was tak­ing respon­si­bil­i­ty for her
sex­u­al abuse: “I brought it on myself: I was sev­en years old and I loved my
dad­dy. I want­ed him to love me, and I did what he want­ed me to do. It was
my own fault.” When I inter­vened to reas­sure her, say­ing, “Come on, you
were just a lit­tle girl—it was your father’s respon­si­bil­i­ty to main­tain the
bound­aries,” Kathy turned toward me. “You know, Bessel,” she said, “I
know how impor­tant it is for you to be a good ther­a­pist, so when you make
stu­pid com­ments like that, I usu­al­ly thank you pro­fuse­ly. After all, I am an
incest survivor—I was trained to take care of the needs of grown-up,
inse­cure men. But after two years I trust you enough to tell you that those
com­ments make me feel ter­ri­ble. Yes, it’s true; I instinc­tive­ly blame myself
for every­thing bad that hap­pens to the peo­ple around me. I know that isn’t
ratio­nal, and I feel real­ly dumb for feel­ing this way, but I do. When you try
to talk me into being more rea­son­able I only feel even more lone­ly and
isolated—and it con­firms the feel­ing that nobody in the whole world will
ever under­stand what it feels like to be me.”
I gen­uine­ly thanked her for her feed­back, and I’ve tried ever since not
to tell my patients that they should not feel the way they do. Kathy taught
me that my respon­si­bil­i­ty goes much deep­er: I have to help them
recon­struct their inner map of the world.
As I dis­cussed in the pre­vi­ous chap­ter, attach­ment researchers have
shown that our ear­li­est care­givers don’t only feed us, dress us, and com­fort
us when we are upset; they shape the way our rapid­ly grow­ing brain
per­ceives real­i­ty. Our inter­ac­tions with our care­givers con­vey what is safe
and what is dan­ger­ous: whom we can count on and who will let us down;
what we need to do to get our needs met. This infor­ma­tion is embod­ied in
the warp and woof of our brain cir­cuit­ry and forms the tem­plate of how we
think of our­selves and the world around us. These inner maps are
remark­ably sta­ble across time.
This doesn’t mean, how­ev­er, that our maps can’t be mod­i­fied by
expe­ri­ence. A deep love rela­tion­ship, par­tic­u­lar­ly dur­ing ado­les­cence, when
the brain once again goes through a peri­od of expo­nen­tial change, tru­ly can
trans­form us. So can the birth of a child, as our babies often teach us how to
love. Adults who were abused or neglect­ed as chil­dren can still learn the
beau­ty of inti­ma­cy and mutu­al trust or have a deep spir­i­tu­al expe­ri­ence that
opens them to a larg­er uni­verse. In con­trast, pre­vi­ous­ly uncon­t­a­m­i­nat­ed
child­hood maps can become so dis­tort­ed by an adult rape or assault that all
roads are rerout­ed into ter­ror or despair. These respons­es are not rea­son­able
and there­fore can­not be changed sim­ply by refram­ing irra­tional beliefs. Our
maps of the world are encod­ed in the emo­tion­al brain, and chang­ing them
means hav­ing to reor­ga­nize that part of the cen­tral ner­vous sys­tem, the
sub­ject of the treat­ment sec­tion of this book.
Nonethe­less, learn­ing to rec­og­nize irra­tional thoughts and behav­ior can
be a use­ful first step. Peo­ple like Mar­i­lyn often dis­cov­er that their
assump­tions are not the same as those of their friends. If they are lucky,
their friends and col­leagues will tell them in words, rather than in actions,
that their dis­trust and self-hatred makes col­lab­o­ra­tion dif­fi­cult. But that
rarely hap­pens, and Marilyn’s expe­ri­ence was typ­i­cal: After she assault­ed
Michael, he had absolute­ly no inter­est in work­ing things out, and she lost
both his friend­ship and her favorite ten­nis part­ner. It is at this point that
smart and coura­geous peo­ple like Mar­i­lyn, who main­tain their curios­i­ty and
deter­mi­na­tion in the face of repeat­ed defeats, start look­ing for help.
Gen­er­al­ly the ratio­nal brain can over­ride the emo­tion­al brain, as long as
our fears don’t hijack us. (For exam­ple, your fear at being flagged down by
the police can turn instant­ly to grat­i­tude when the cop warns you that
there’s an acci­dent ahead.) But the moment we feel trapped, enraged, or
reject­ed, we are vul­ner­a­ble to acti­vat­ing old maps and to fol­low their
direc­tions. Change begins when we learn to “own” our emo­tion­al brains.
That means learn­ing to observe and tol­er­ate the heart­break­ing and gut-
wrench­ing sen­sa­tions that reg­is­ter mis­ery and humil­i­a­tion. Only after
learn­ing to bear what is going on inside can we start to befriend, rather than
oblit­er­ate, the emo­tions that keep our maps fixed and immutable.
LEARNING TO REMEMBER
About a year into Marilyn’s group, anoth­er mem­ber, Mary, asked
per­mis­sion to talk about what had hap­pened to her when she was thir­teen
years old. Mary worked as a prison guard, and she was involved in a
sado­masochis­tic rela­tion­ship with anoth­er woman. She want­ed the group to
know her back­ground in the hope that they would become more tol­er­ant of
her extreme reac­tions, such as her ten­den­cy to shut down or blow up in
response to the slight­est provo­ca­tion.
Strug­gling to get the words out, Mary told us that one evening, when
she was thir­teen years old, she was raped by her old­er broth­er and a gang of
his friends. The rape result­ed in preg­nan­cy, and her moth­er gave her an
abor­tion at home, on the kitchen table. The group sen­si­tive­ly tuned in to
what Mary was shar­ing and com­fort­ed her through her sob­bing. I was
pro­found­ly moved by their empathy—they were con­sol­ing Mary in a way
that they must have wished some­body had com­fort­ed them when they first
con­front­ed their trau­mas.
When time ran out, Mar­i­lyn asked if she could take a few more min­utes
to talk about what she had expe­ri­enced dur­ing the ses­sion. The group
agreed, and she told us: “Hear­ing that sto­ry, I won­der if I may have been
sex­u­al­ly abused myself.” My mouth must have dropped open. Based on her
fam­i­ly draw­ing, I had always assumed that she was aware, at least on some
lev­el, that this was the case. She had react­ed like an incest vic­tim in her
response to Michael, and she chron­i­cal­ly behaved as if the world were a
ter­ri­fy­ing place.
Yet even though she’d drawn a girl who was being sex­u­al­ly molest­ed,
she—or at least her cog­ni­tive, ver­bal self—had no idea what had actu­al­ly
hap­pened to her. Her immune sys­tem, her mus­cles, and her fear sys­tem all
had kept the score, but her con­scious mind lacked a sto­ry that could
com­mu­ni­cate the expe­ri­ence. She reen­act­ed her trau­ma in her life, but she
had no nar­ra­tive to refer to. As we will see in chap­ter 12, trau­mat­ic mem­o­ry
dif­fers in com­plex ways from nor­mal recall, and it involves many lay­ers of
mind and brain.
Trig­gered by Mary’s sto­ry, and spurred on by the night­mares that
fol­lowed, Mar­i­lyn began indi­vid­ual ther­a­py with me in which she start­ed to
deal with her past. At first she expe­ri­enced waves of intense, free-float­ing
ter­ror. She tried stop­ping for sev­er­al weeks, but when she found she could
no longer sleep and had to take time off from work, she con­tin­ued our
ses­sions. As she told me lat­er: “My only cri­te­ri­on for whether a sit­u­a­tion is
harm­ful is feel­ing, ‘This is going to kill me if I don’t get out.’”
I began to teach Mar­i­lyn calm­ing tech­niques, such as focus­ing on
breath­ing deeply—in and out, in and out, at six breaths a minute—while
fol­low­ing the sen­sa­tions of the breath in her body. This was com­bined with
tap­ping acu­pres­sure points, which helped her not to become over­whelmed.
We also worked on mind­ful­ness: Learn­ing to keep her mind alive while
allow­ing her body to feel the feel­ings that she had come to dread slow­ly
enabled Mar­i­lyn to stand back and observe her expe­ri­ence, rather than
being imme­di­ate­ly hijacked by her feel­ings. She had tried to damp­en or
abol­ish those feel­ings with alco­hol and exer­cise, but now she began to feel
safe enough to begin to remem­ber what had hap­pened to her as a girl. As
she gained own­er­ship over her phys­i­cal sen­sa­tions, she also began to be
able to tell the dif­fer­ence between past and present: Now if she felt
someone’s leg brush against her in the night, she might be able to rec­og­nize
it as Michael’s leg, the leg of the hand­some ten­nis part­ner she’d invit­ed to
her apart­ment. That leg did not belong to any­one else, and its touch didn’t
mean some­one was try­ing to molest her. Being still enabled her to know—
ful­ly, phys­i­cal­ly know—that she was a thir­ty-four-year-old woman and not
a lit­tle girl.
When Mar­i­lyn final­ly began to access her mem­o­ries, they emerged as
flash­backs of the wall­pa­per in her child­hood bed­room. She real­ized that this
was what she had focused on when her father raped her when she was eight
years old. His molesta­tion had scared her beyond her capac­i­ty to endure, so
she had need­ed to push it out of her mem­o­ry bank. After all, she had to
keep liv­ing with this man, her father, who had assault­ed her. Mar­i­lyn
remem­bered hav­ing turned to her moth­er for pro­tec­tion, but when she ran to
her and tried to hide her­self by bury­ing her face in her mother’s skirt, she
was met with only a limp embrace. At times her moth­er remained silent; at
oth­ers she cried or angri­ly scold­ed Mar­i­lyn for “mak­ing Dad­dy so angry.”
The ter­ri­fied child found no one to pro­tect her, to offer strength or shel­ter.
As Roland Sum­mit wrote in his clas­sic study The Child Sex­u­al Abuse
Accom­mo­da­tion Syn­drome: “Ini­ti­a­tion, intim­i­da­tion, stigma­ti­za­tion,
iso­la­tion, help­less­ness and self-blame depend on a ter­ri­fy­ing real­i­ty of child
sex­u­al abuse. Any attempts by the child to divulge the secret will be
coun­tered by an adult con­spir­a­cy of silence and dis­be­lief. ‘Don’t wor­ry
about things like that; that could nev­er hap­pen in our fam­i­ly.’ ‘How could
you ever think of such a ter­ri­ble thing?’ ‘Don’t let me ever hear you say
any­thing like that again!’ The aver­age child nev­er asks and nev­er tells.”3
After forty years of doing this work I still reg­u­lar­ly hear myself say­ing,
“That’s unbe­liev­able,” when patients tell me about their child­hoods. They
often are as incred­u­lous as I am—how could par­ents inflict such tor­ture and
ter­ror on their own child? Part of them con­tin­ues to insist that they must
have made the expe­ri­ence up or that they are exag­ger­at­ing. All of them are
ashamed about what hap­pened to them, and they blame themselves—on
some lev­el they firm­ly believe that these ter­ri­ble things were done to them
because they are ter­ri­ble peo­ple.
Mar­i­lyn now began to explore how the pow­er­less child had learned to
shut down and com­ply with what­ev­er was asked of her. She had done so by
mak­ing her­self dis­ap­pear: The moment she heard her father’s foot­steps in
the cor­ri­dor out­side her bed­room, she would “put her head in the clouds.”
Anoth­er patient of mine who had a sim­i­lar expe­ri­ence made a draw­ing that
depicts how that process works. When her father start­ed to touch her, she
made her­self dis­ap­pear; she float­ed up to the ceil­ing, look­ing down on some
oth­er lit­tle girl in the bed.4 She was glad that it was not real­ly her—it was
some oth­er girl who was being molest­ed.
Look­ing at these heads sep­a­rat­ed from their bod­ies by an impen­e­tra­ble
fog real­ly opened my eyes to the expe­ri­ence of dis­so­ci­a­tion, which is so
com­mon among incest vic­tims. Mar­i­lyn her­self lat­er real­ized that, as an
adult, she had con­tin­ued to float up to the ceil­ing when she found her­self in
a sex­u­al sit­u­a­tion. In the peri­od when she’d been more sex­u­al­ly active, a
part­ner would occa­sion­al­ly tell her how amaz­ing she’d been in bed—that
he’d bare­ly rec­og­nized her, that she’d even talked dif­fer­ent­ly. Usu­al­ly she
did not remem­ber what had hap­pened, but at oth­er times she’d become
angry and aggres­sive. She had no sense of who she real­ly was sex­u­al­ly, so
she grad­u­al­ly with­drew from dat­ing altogether—until Michael.
HATING YOUR HOME
Chil­dren have no choice who their par­ents are, nor can they under­stand that
par­ents may sim­ply be too depressed, enraged, or spaced out to be there for
them or that their par­ents’ behav­ior may have lit­tle to do with them.
Chil­dren have no choice but to orga­nize them­selves to sur­vive with­in the
fam­i­lies they have. Unlike adults, they have no oth­er author­i­ties to turn to
for help—their par­ents are the author­i­ties. They can­not rent an apart­ment or
move in with some­one else: Their very sur­vival hinges on their care­givers.
Chil­dren sense—even if it they are not explic­it­ly threatened—that if
they talked about their beat­ings or molesta­tion to teach­ers they would be
pun­ished. Instead, they focus their ener­gy on not think­ing about what has
hap­pened and not feel­ing the residues of ter­ror and pan­ic in their bod­ies.
Because they can­not tol­er­ate know­ing what they have expe­ri­enced, they
also can­not under­stand that their anger, ter­ror, or col­lapse has any­thing to
do with that expe­ri­ence. They don’t talk; they act and deal with their
feel­ings by being enraged, shut down, com­pli­ant, or defi­ant.
Chil­dren are also pro­grammed to be fun­da­men­tal­ly loy­al to their
care­tak­ers, even if they are abused by them. Ter­ror increas­es the need for
attach­ment, even if the source of com­fort is also the source of ter­ror. I have
nev­er met a child below the age of ten who was tor­tured at home (and who
had bro­ken bones and burned skin to show for it) who, if giv­en the option,
would not have cho­sen to stay with his or her fam­i­ly rather than being
placed in a fos­ter home. Of course, cling­ing to one’s abuser is not exclu­sive
to child­hood. Hostages have put up bail for their cap­tors, expressed a wish
to mar­ry them, or had sex­u­al rela­tions with them; vic­tims of domes­tic
vio­lence often cov­er up for their abusers. Judges often tell me how
humil­i­at­ed they feel when they try to pro­tect vic­tims of domes­tic vio­lence
by issu­ing restrain­ing orders, only to find out that many of them secret­ly
allow their part­ners to return.
It took Mar­i­lyn a long time before she was ready to talk about her
abuse: She was not ready to vio­late her loy­al­ty to her family—deep inside
she felt that she still need­ed them to pro­tect her against her fears. The price
of this loy­al­ty is unbear­able feel­ings of lone­li­ness, despair, and the
inevitable rage of help­less­ness. Rage that has nowhere to go is redi­rect­ed
against the self, in the form of depres­sion, self-hatred, and self-destruc­tive
actions. One of my patients told me, “It is like hat­ing your home, your
kitchen and pots and pans, your bed, your chairs, your table, your rugs.”
Noth­ing feels safe—least of all your own body.
Learn­ing to trust is a major chal­lenge. One of my oth­er patients, a
school­teacher whose grand­fa­ther raped her repeat­ed­ly before she was six,
sent me the fol­low­ing e‑mail: “I start­ed mulling the dan­ger of open­ing up
with you in traf­fic on the way home after our ther­a­py appoint­ment, and
then, as I merged into Route 124, I real­ized that I had bro­ken the rule of not
get­ting attached, to you and to my stu­dents.”
Dur­ing our next meet­ing she told me she had also been raped by her lab
instruc­tor in col­lege. I asked her whether she had sought help and made a
com­plaint against him. “I couldn’t make myself cross the road to the
clin­ic,” she replied. “I was des­per­ate for help, but as I stood there, I felt
very deeply that I would only be hurt even more. And that might well have
been true. Of course, I had to hide what had hap­pened from my par­ents—
and from every­one else.”
After I told her that I was con­cerned about what was going on with her,
she wrote me anoth­er e‑mail: “I’m try­ing to remind myself that I didn’t do
any­thing to deserve such treat­ment. I don’t think I have ever had any­one
look at me like that and say they were wor­ried about me, and I am hold­ing
on to it like a trea­sure: the idea that I am worth being wor­ried about by
some­one I respect and who does under­stand how deeply I am strug­gling
now.”
In order to know who we are—to have an identity—we must know (or
at least feel that we know) what is and what was “real.” We must observe
what we see around us and label it cor­rect­ly; we must also be able trust our
mem­o­ries and be able to tell them apart from our imag­i­na­tion. Los­ing the
abil­i­ty to make these dis­tinc­tions is one sign of what psy­cho­an­a­lyst William
Nieder­land called “soul mur­der.” Eras­ing aware­ness and cul­ti­vat­ing denial
are often essen­tial to sur­vival, but the price is that you lose track of who
you are, of what you are feel­ing, and of what and whom you can trust.5
REPLAYING THE TRAUMA
One mem­o­ry of Marilyn’s child­hood trau­ma came to her in a dream in
which she felt as if she were being choked and was unable to breathe. A
white tea tow­el was wrapped around her hands, and then she was lift­ed up
with the tow­el around her neck, so that she could not touch the ground with
her feet. She woke in a pan­ic, think­ing that she was sure­ly going to die. Her
dream remind­ed me of the night­mares war vet­er­ans had report­ed to me:
see­ing the pre­cise, unadul­ter­at­ed images of faces and body parts they had
encoun­tered in bat­tle. These dreams were so ter­ri­fy­ing that they tried to not