The Permanente Journal

Search the Journal 
  Site Index
TPJ Home pageBrowse The JournalSubscribe to TPJInstructions for AuthorsContinuing Medical EducationAnnouncementsLinksJournal StaffEmail Us


A Focus on Preventive Care:
••Winter 2004/Vol. 8, No. 1

Editorial CommentsComments from the Journal EditorsAbstracts from articles published in other journals
CommentaryClinical articles on the practice of Permanente medicine
Poetry, Art, Musings from Permanente cliniciansKP in the Community
Articles from a Systems perspective
Medical EthicsPhysicians in the news
Book ReviewsLighter side of medicine crossword puzzle

 

 

 

 

 

 

 

 


Soul of the Healer


Giving Pain a Voice | pdf >>

By Mary Shannon, MSW

Flashback: "A recurring, intensely vivid mental image of a past traumatic experience."

"Six months after I gave birth to my son I started having flashbacks," Kate told me in our first psychotherapy session. Her physician had referred her to me, suspecting that her multiple physical problems had psychosocial components.

"I didn't tell anyone about them, not even my husband," she continued. "I was afraid if I told anyone they'd think I was crazy, or at the very least on my way to going crazy, so I kept them a secret. At first they happened infrequently, which made them easier to ignore. But as time went on, they nudged their way into my life like unwelcome visitors that refused to leave, poking and prodding and picking away at me until one day I realized ignoring them was no longer an option."

"The most painful flashback was the one that recurred most often," she recalled. "I saw myself as a little girl again, helpless, standing like a trapped animal at the foot of mom's bed. She was laying on her back, telling me to come closer to her--first in the kind of voice people use when they want you to do something, then in a harsh, frustrated voice when I still didn't move. I shook my head 'no,' praying she'd change her mind and leave me alone, but I could tell from the look on her face I'd better do as she said. I slowly made my way around the bed to stand beside her, making sure to stand just far enough away so she couldn't grab me unless she sat up. She reached out for me, telling me again to come closer, but I didn't budge. Mom didn't say anything--she didn't have to. Her eyes narrowed to a steady glare and said it all. The little girl took a slow, small step toward the bed. I could feel the queasiness in the pit of her stomach, the tickling sensation of tears running down her face as they ran down mine."

After each flashback, Kate convinced herself that the past was better left in the past, shrugging off those images like you shrug off a chill that comes out of nowhere, determined to move on with her life. "I was married to a respected physician, had a beautiful new baby to care for, and had just received my Masters degree in Social Work. I didn't have time to deal with memories I'd worked so hard to forget!" she cried. But memories are strange things, especially painful memories. Sometimes they come at you all at once, like blinding strikes of lightening replaying scenes from the past like two-second horror shows in your head. Other times they trickle into your life like a slow poison, eating away at you until the line between the past and the present is so blurred you can't tell the difference between the two anymore. The hardest part is not knowing which ones are waiting in your psyche to revisit you, since they choose you--you don't choose them. Each flashback handed Kate a different memory, and each memory triggered another. "It was like going home again a little bit at a time," she told me, "only I never knew when I was going, or what I was going to find when I got there."

I encouraged Kate to write about her past, and the following narrative excerpts have been reprinted with her permission.

"It started when I was young, about four or five years old from what I can remember. That's when the other things started too--the self-hatred, the shame, the self-mutilation. I remember trying to pretend I was like all the other kids, but even then I knew I'd always be an outsider--different from the rest. Other kids didn't have secrets like I did. They seemed safe and sure about everything, while I jumped at my own shadow. My secret consumed me, isolated me, tormented me. There was no one to tell. It was the late 1950s, then the 1960s--no one imagined such things, much less talked about them. Besides, I was too ashamed to admit my mother made me touch her. Too afraid I'd be labeled a freak. Who was I that my own mother would do such horrible things to me? What was wrong with me?"

"As I got older, I began to have multiple physical problems, from severe headaches to gastrointestinal problems that finally resulted in exploratory surgery when I was a teenager. Of course nothing was discovered. No one ever asked the question, 'How are things at home?' They just did another test, scheduled another surgery. No one realized, not even me, that my body was trying to give my pain a voice, because I couldn't."

"Even as an adult, there was still no one to tell. My husband only knew bits and pieces because he didn't want to hear any more than that, and whenever I tried to deepen a friendship by sharing a little of my past, the friendship quickly ended. There were no support groups for a woman like me either, so I kept it buried, pretended I was like everyone else. Lied, in order to be accepted. But I still wasn't accepted. My world was so different from everyone else's that there was no connection, no common ground. I couldn't laugh as others laughed."

"It wasn't until years later that I began working with a therapist who encouraged me to write about my past, which proved to be a significant breakthrough for me. I'd already discovered the benefits of art therapy, having done it both personally, as well as professionally with cancer patients. But I was at a point where I needed more than the abstract use of color and form. I needed to put words to the events and feelings that had been haunting me. I needed to give my pain a concrete voice."

"On a cold January morning I sat down at my computer and started writing. I wrote until I couldn't stand to put down another word, then I took a break, took a deep breath and wrote some more. Whenever the feelings were too overwhelming I'd take another break. I wrote in fits and starts, wrote in my journal, on the computer, in my mind. Sometimes I wrote for hours on end. It was as if the words had finally found a way out and didn't want to stop. The more I wrote, the more I was able to understand. The more I wrote, the more I was able to let compassion take seed. The more I wrote, the more I was able to construct a whole self, instead of denying and burying half my life. The more I wrote, the more I was able to give that little girl a voice--and when that happened, I started to laugh as others laugh."

Writing allowed Kate to take the horror within and make it manageable. "I become a witness to my own experience, integrating it into my life instead of suppressing it," she stated. Louise DeSalvo says, "Through writing, we change our relationship to trauma, for we gain confidence in ourselves and in our ability to handle life's difficulties."1 At the end of our last session, Kate left me a thank you card. In it, she remarked on the healing benefits of writing: "As I watch my words, phrases and paragraphs come together on the page, I can sometimes feel the weight of silence begin to lift, the burden of isolation start to disintegrate. And all the while, deep in the shadows, the little girl is smiling."

"Statistically, one in three women have been molested as children."2 In a 1997 groundbreaking report of daughters sexually abused by mothers, it's stated that "sexual abuse by females and mothers is occurring daily but remains very hidden." Bobbie Rosencrans, MSW, goes on to say "... very little permission in this society is given for women to be so far outside the stereotypes and social rules for women, especially mothers."3 At one time this same social rule applied to fathers, but now we have accepted the fact that father-daughter incest is a sadly prevalent occurrence, and because we can finally speak this truth, there is help for both. But until mother-daughter sexual abuse is "out of the closet," the cycle of shame and isolation will continue to dominate the lives of countless mothers and daughters.

Because of a great deal of hard work, the cycle of abuse has stopped with Kate. Her son is now a happy, healthy teenager who continues to amaze and delight her, and her marriage of 22 years is stronger than ever. In allowing me to share her own unspeakable truth here, our hope is to increase awareness of this hidden, yet prevalent form of abuse, and consequently encourage the development of resources for those who have carried this secret in their lives for too many years. As Kate said during our last meeting, "Perhaps one day I'll even meet a woman like me--a woman who finally has someplace to go, and someone to tell. That will be the day when I won't have to be alone with my secret any more, and neither will she."

Note: Parts of this article have been excerpted from Ms Shannon's upcoming book, "The Sunday Wishbone." No part of this article may be reprinted or used in any way without written permission from the author.

References

  1. DeSalvo L. Writing as a way of healing: how telling our stories transforms our lives. New York:
    Harper San Francisco; 1999.
  2. Borysenko J. A woman's book of life. New York: Riverhead Books; 1996.
  3. Rosencrans B. The last secret: daughters sexually abused by mothers. Brandon (VT): Safer Society Press; 1997.

 

 

To full contents list >>

 


Home | The Journal | Subscribe | For Authors | CME | Announcements | Links | Staff | Contact Us


The Permanente Journal

500 NE Multnomah St., Suite 100,
Portland, OR 97232
503-813-3286 / fax: 503-813-2348


Copyright The Permanente Journal, Kaiser Permanente. All rights reserved