Sexual Trauma in Context with Inescapable Stressors

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Sexual Trauma Within the Context of Traumatic and Inescapable Stress, Neglect, and Poisonous Pedagogy

 

by Mark F. Schwartz, Lori D. Galperin, and William H. Masters

 


Post-traumatic Stress

The Diagnostic Statistical Manual-III (DSM-III) defines posttraumatic stress disorder (PTSD) as the result of a recognizable stressor that would evoke significant symptoms of distress in almost anyone (American Psychiatric Association, 1987, p. 236). The implication of this terminology is that the natural response to such trauma is PTSD — that the response is not an “illness” and that any person experiencing an event of that magnitude is likely to be similarly affected. Thus, rather than stigmatizing trauma victims by assigning to them a mental disorder, it might be more reasonable to categorize the adaptive and maladaptive survival strategies, describe such individuals as “survivors” and then label the “pathological intensifications” (Horowitz,1986) of such strategies as a mental disorder.

Because a child’s natural defenses include dissociation — even amnesia — the cycling of numbing and intrusion responses that predictably occur following posttraumatic stress (Horowitz, 1986) may continue to cycle indefinitely. The numbing portion of the cycle involves a person feeling like an object, treating others like objects, and responding objectively without the use of emotions to guide actions and without the capacity for genuine caring and compassion for self or others. Therefore, the numbing results in restrictive, self-punitive responses, as well as constriction, isolation, and disconnection from others.

Intrusion is the breaking through or flooding in of cognition or affect that overwhelms the individual. Typically, it is coded as anxiety, depression, or some other generalized distress, such as somatic complaints. Ritualized or compulsive behavior is often used to cope with this distress or to numb out further, which adds to the individual’s disability. Specifically, when the intrusion phase begins, compulsive behavior may function as a vehicle for the re-creation of numbness. When the numbing becomes intolerable (i.e., when the person feels so removed, inhuman, or unreal that all connection to self, others, and physical reality feels lost), compulsive behavior or rituals are then used to reestablish feeling.

It is likely that without external guidance and support from caregivers, the result of early trauma will be pathological intensification or mental disorder. Thus, the impact of trauma can be measured only by assessing both event and context (i.e., the presence or absence of nurturing and support from the caregivers). With sufficient support, the trauma may be “finished,” “worked through,” or resolved without any resulting pathological intensifications.

Disorders of Extreme Stress (DES)

Whenever a person experiences severe and chronic stress that is inescapable for prolonged periods, the resulting syndrome is predictably different from that of a posttraumatic stress, which consists of an overwhelming acute event that has a termination point. There is also a vast literature reviewed by van der Kolk (1989) that suggests that the physiologic concomitants of chronic, inescapable stress are different from those for acute stress. For many children who experience PTSD, there is a backdrop of stress in the day-to-day atmosphere of abuse, neglect, and danger to which some children are subjected both in and out of their homes. Whenever children are afraid to walk inside their homes because of chaotic, unprovoked, and inconsistent rage and hostility randomly projected onto family members, the environment can be considered similar to inescapable stress (DES).


Children who are chronically traumatized by their caretakers may have experiences similar to those of torture victims.


For such children, witnessing molestation, seeing one parent beaten or raped by the other parent, being locked in hot cars on summer days, or almost being drowned in bathtubs culminates in a pervasive sense of unpredictability, danger, and terror. Whenever such episodic posttraumatic stress occurs in the context of this pervasive, overwhelming, chronic stress, the long-term effects will be much more devastating. Judith Hennan (1992) and Bessel van der Kolk (1993) have recently reviewed the existing literature and suggested that the distorted survival strategies that result from inescapable stress in humans include, predictably, depression and anxiety; somatic symptoms; dissociative symptoms; compulsive reenactment; susceptibility to revictimization; intimacy and relationship disorders; and some personality adaptation in the borderline, narcissistic, antisocial, or schizoid realm.

Children who are chronically traumatized by caretakers in an environment of endemic family stress may have experiences similar to those of torture victims, which include the creation of dependency, intimidation, disorientation, and isolation (Suedfeld, 1990) Children, by definition, are dependent on caretakers. Abusive parents further engender torturous dependency by withholding basic care and opportunity. When children are forced to submit and obey as the price for being allowed cleanliness, food, clothing, access to friends, or just momentary respite from abuse, they are made into slaves. Their fates become entirely contingent on the whims of the captors/parents, and their realities reshape to fit the rules of the game, The name of the game is the subjugation of vulnerable, trusting, and ultimately desperate children by adults who are often powerless everywhere else in the world.

If children believe that they are in mortal danger and that the threat is embodied by the people on whom they are most reliant, the result is a feeling of such profound powerlessness that any will to continue is totally eradicated. Therefore, resilient children bounce back through an instinctive reframing of their environments that restores hope: They conclude that they are bad and have caused their own suffering, that their caregivers truly love them, and that if they can only try harder — or be better — everything will change. To wit: They are not without love and need only perfecting to be truly deserving.

The shame and isolation of “the secret” often compounds and reinforces these dynamics. When the secret is sexual abuse, children often have been told an array of confusing lies: “I love you best of all.” “This is our little secret.” “If your mother knew, she wouldn’t love you, she would know you’re a bad little girl,” and so on. These confusional techniques occur together with the disorientation of overwhelming, incomprehensible stimulation, which is often accompanied by excruciating physical pain. The mood of the torturer changes radically from one moment to the next: A kiss on the cheek follows a pillow over the face that nearly ends life. The isolating shame and secrecy further reinforce dependency on the torturer: “You’re my special one.” “If anyone else knew, they would hate you, but you’ll always have me.”

The longer the abuse continues, the more bound to the abusers the children feel and the more removed they become from other potential connections. The longer the abuse continues with no intervention, the more certain children become that they are not worth saving. Our culture is one in which adults are deemed more aware and knowledgeable than children. Mothers in particular seem to know things magically that children think are unknown. Likewise, the God of Western culture is considered to be all-knowing — even Santa Claus has inside information and knows if you’ve been bad or good. Amid all of these mythologies and belief systems, how can children imagine that no one notices? When intact, a parent’s position is in some measure a buffer or insulator between the child and the dangers of the world. A child being abused by his or her father can have one of two beliefs about his or her mother:

“She knows but I’m not worth saving” or, “She doesn’t know and I have absolutely no one capable of protecting me.” Again, it becomes more acceptable to feel bad and unworthy than at the mercy of all the world’s dangers. The net effect of the required adaptations to this array of implicit double binds is comparable, in essence, to those arising from intentional brainwashing. The process is the same: Bonds are severed, disorientation is engendered by deprivation or overstimulation, confusion is engendered by double messages and contradictions without resolution, and dependency on the torturer for cessation of the suffering is implicit.

This result may be intended or merely a by-product of domestic cycles of ABUSE! and neglect, but the damage is of atleast comparable and perhaps greater magnitude in domestic circumstances because the children’s/prisoners’ ego formation is still unfolding and parents’ access to the children is total. Virulency of trauma is increased by factors such as premeditation, maliciousness, and the possibility of recurrence.


For child victims, chronic, learned helplessness often renders them targets for further victimization throughout life.


For natural disaster and kidnap victims, as well as POWs, there is the hope that one day the experience will end. There may be the remembrance of a time of normalcy or happiness. However, for the child victim of domestic violence, this is reality as far as the eye can see — both backward and forward. For child victims, even when the abuse stops, the cycle often does not because the chronic, learned helplessness still renders them targets for further victimization throughout life. Their capacity to say “No” seems to be permanently injured. Initially, there are cycles of protest, despair, and apathy (Bowlby, 1969) until apathy finally becomes a relatively constant state and the individual succumbs.

Neglect

Alice Miller (1983, 1986) has written about the hidden cruelties of our philosophy and practice of child rearing as a society — what she calls poisonous pedagogy. Underlying such philosophies is a belief that children are impulsive, out-of control creatures who require discipline to rein them in and civilize them. Instead of recognizing their acting-out behavior as the result of not feeling loved, attended to, and nurtured, parents assume that the behavior is a result of “badness.” Therefore, they feel entitled to punish, deprive, neglect, scream at, or threaten to or actually abandon such “bad” children. In so doing, they believe that they are acting in the best interests of the children.

Children learn not to question such disciplinary tactics for fear that worse will follow. When the children respond with anger to being treated unfairly, they are often punished more and told by the angry and sometimes out-of­control parents (ironically) that anger is not permitted, i.e., “Don’t you talk back to me, young lady” or “If you cry, I’ll give you something to cry about”— a compelling indication that no emotional response is permissible. Therefore, children learn to suppress their natural responses to abuse, which creates a broadening of psychopathology. Paradoxically, health care workers can co-conspire with families when acting-out children are scapegoated and taken to professionals to get “treated” or to be made “well.”

It is only against the backdrop of poisonous pedagogy that the devastating impact of sexual and physical abuse, both acute and chronic, can be fully comprehended. To fully assess the extent of injury and the necessary and sufficient components of rehabilitation for the victims, we must consider the acute PTSD; the chronic, extreme stress that constitutes the context of the trauma and the neglect — and societal response. Children are totally dependent on adults for life itself, and society’s attitude commonly has been one of ownership, that is, that parents have the right to bring up their children any way they wish. Within this pedagogical context, children assume that sexual abuse, for example, is a form of punishment, something they deserve for being bad—something being done” for their own good” by adults who know what’s best. In addition to the indigenous poisonous pedagogy, there is in our culture’s conceptualization of childrearing a very poor articulation of what all children require to thrive. The result is that parents, children, professionals, and state agencies cannot define neglect adequately.

Neglect is the absence of what all children need to thrive, but of what does that consist? When children are neglected, they feel unlovable. Typically, it does not occur to them to think that their caregivers are imperfect, incompetent, incapable of loving, or, at the worst, sadistic. To define a standard of comparison, one might simply ask: What is the impact on a child of having two parents, each of whom is tremendously selfish and self-absorbed, each of whom puts his or her needs above those of everyone else, 100% of the time? What is the damage, even though no overt abuse occurred? In some ways, neglect may be more pernicious than abuse, but because the two often occur together, it becomes quite difficult to determine which is most injurious or exactly where the damage of one ends and the other begins.

All children need respect, consistency, attention, support, role models, praise, protection, loving touch, assurance, and play as much as they need food and shelter. Children need opportunities to learn and make mistakes without pressure or punishment. They need to be accepted as unique, not considered replicas of their parents or older siblings, and they should be encouraged in self-expression, even when their opinions are different from those of their parents and teachers. They need to be let in on the secret that adults are imperfect, and that sometimes children are right and caretakers are not. They need to be provided with developmentally appropriate challenges and choices so that they develop the ability to evaluate, learn, and, most of all, trust themselves. Finally, as children mature neuromuscularly, they must gradually separate from caregivers and establish a sense of autonomy to operate effectively in a constantly changing environment.

Too often, the aims of child rearing are discipline and submission rather than guidance and appropriate limits. The tactics used are reflective of the underlying goal and rely heavily on shame induction (Bad boy! Bad girl!); threats of abandonment and the withdrawal of love; obedience, conformity, and never questioning authority; and the suppression of what is natural, spontaneous, and unique. If socialized properly, children are supposed to collude with ease and never say, “The emperor has no clothes!” Hence, they must disqualify their own sensory experiences and not see or be aware of everyday discrepancies and injustices; in a modern technological society, the problems become compounded.

In 20th Century Western culture, children get material possessions, but have few opportunities to develop their creativity: Emphasis is placed on meeting needs externally rather than developing internal capacities.

Values become imposed or imbibed from the outside rather than cultivated from within. Often, there is the hypocrisy of “do as I say, not as I do,” and achievement and attainment are worshipped as the new twin gods of modem existence. Children quickly learn that achievement equals desirability, and self-image becomes linked to what they have, do, and can get, rather than any durable sense of intrinsic worth.

As they get older, they lack the ability for introspection or simple enjoyment and instead feel increasingly driven to attain and acquire more and more in order to escape the feeling of inner emptiness. There is confusion as to what exactly is important and when it becomes enough, and all play becomes impossible unless it is linked to achievement. Because so many children today grow up with deficits of this type, there are high levels of endemic societal distress that, being so widespread, go unlabeled as dysfunctional. Children who lack basic internal resources are even less equipped to contend with the additional and extreme demands that acute and/or chronic stress generate. They have nowhere to tum, either externally or internally.

The sexually traumatized individual, particularly the victim of incest, is typically dealing with post-traumatic stress, DES, neglect, and poisonous pedagogy simultaneously. For this reason, therapy rarely can be focused only on the multiple rapes. Instead, individuals must eventually recognize both what they deserved to get but did not and what they got that they did not deserve, and grieve these multiple losses within the context of a nurturing therapeutic relationship. Then, they need to be given the opportunity and guidance to be able to learn new habits and skills that are different from those derived within the original abusive, neglectful environment.

Encapsulation Syndromes

Even if children are counseled soon after being raped, they are often unable to disclose or remember the details verbally. They can reenact the abuse with dolls or recreate the details through drawings, but there seems to be impairment in cognitive verbal articulation. This phenomenon is reflective of dissociation, which is the separation or non-integration of trauma-related emotions, thoughts, sensations, or behaviors.

(Braun, 1988), DSM-III defines dissociation as a disturbance or alteration in the normally integrative function of identity, memory, or consciousness (American Psychiatric Association, 1987, p. 253). For abused children, dissociation is an automatic survival strategy. It enables children to deflect traumatic experiences into a separate consciousness, making daily functioning possible. Thus, a child who is raped by his or her father before going to school in the morning is still able to go to school, participate in class, and interact with peers two hours later. Through disassociation, the child is able to believe that “it didn’t happen.” “It didn’t happen to me,” or, “It happened to someone else.” The cost of such rigid compartmentalization is that the child’s development is fixated or impaired with each traumatic experience. Each experience provides a new block of unintegrated material and a further break in the continuity of experience and consciousness. Summit (1983) describes the child as encapsulated within a bubble and feeling dirty, bad, damaged, or defective.

Although the individual continues to age developmentally and acquire new skills and life experiences, this part of the self does not seem to age. New experiences do not penetrate the semipermeable membrane, leaving the individual with the original core beliefs of defectiveness unaltered and, therefore, regardless of achievements, feeling like an imposter. It is as though the adult has developed a functional persona as an overlay, but the core “defective child” remains unintegrated. To many adults, the lack of integration may be experienced as an absence or a void — the empty, unfillable hole in their abdomen — that they attempt to assuage with addictive consuming.

By dissociating, the individual is prevented from registering the pain that would shatter functioning, but is likewise prevented from expression of the strong feelings and grieving necessary for completion of the stress-response cycle. This unexpressed emotion that the encapsulated bubble contains periodically intrudes as rage, which is either acted out or directed inward.


Dissociated aspects of trauma may leak back into consciousness, causing cycles of intrusion and numbing.


Deprived of any memories of the traumatic events in which these feelings originate, and with a distorted perception caused by the parents’ destructive parenting behavior, the child, and ultimately the adult, is left feeling defective, bad, ashamed, and isolated, which affects how he or she relates to others.

Dissociated aspects of trauma also may leak back into consciousness; causing cycles of intrusion and numbing and result in feelings of terror, powerlessness, and rage. Flashbacks to more specific elements of the original trauma or conflict may also occur. Emerging in this out-of-context manner, they typically cause the individual to feel “crazy” or hopelessly out of control of his or her mind and body, Identity, esteem, body image, sense of personal power, effectiveness, trust, and intimacy are so damaged that personal relationships become unstable and tumultuous. These traits have traditionally been labeled as “borderline,” but would be better characterized as “accommodations syndromes,” to emphasize that individuals’ perceptions are reasonable within the context of their trauma-engendered accommodations to the perceived developmental events.

Repetitions

Horowitz (1986), who has studied the adaptations to severe stressors in childhood and adulthood, has suggested that the common, “natural” result of severe trauma is repetition, which consists of flashbacks, intrusions and reenactment, until there is completion or mastery of the original, overwhelming stress. Such mastery requires that individuals relive their experiences, revising the age-specific cognitive confusion and releasing the intense emotions. If the stress response cycle is not successfully completed, individuals may reenact disguised repetitions with accompanying numbing and intrusions throughout their lives. (For example, some battered children and battered monkey infants grow up to batter their children; see Table1.1 for more examples.) As has already been noted, the most potent coping strategy for childhood trauma is dissociation, and the dissociative process by definition interferes with completion of, mastery of, or working through the trauma. The result is that most victims of childhood trauma are left to repeat in disguised form, ad infinitum, the events that are too terrifying to remember.

Table 1.1 lists clinical examples of reenactment. These compulsive reenactments — often revolving around themes of self-punishment, self­cutting, hypersexuality, workaholism, binge or purge eating, or thematically repetitive, destructive relational attachments — become ritualized expressions of unresolved trauma. The habitual behaviors serve as a regulatory mechanism and thereby contain “unmetabolized” trauma as previously described, mediating the cycle of intrusion to cause numbing, and the cycle of numbing to create the capacity to feel. Compounding the problem, these reenactments may also become part of addictive cycles due to the “high” from endorphin release triggered by the flash­back of the original trauma (van der Kolk, 1989). Likewise, the pleasure and stress release of the habituated act further perpetuates the habit. Thus, the factors that maintain destructive behavior may become independent of the factors that originally caused them.

These reenactments can become a distraction from the emptiness and isolation that have resulted from trauma and dissociation, giving the individual the illusion of connectedness, power, and control, as well as brief, illusory relief from chronic loneliness and dysphoria. In this context, compulsions serve as clues, or windows, to the original abuse in and out of the family, and they maintain survival in what feels like a situation of potential annihilation. More and more it becomes clear that an essential component in alleviating compulsion is identifying its original source and understanding both its original and continuing functions.

When mental health professionals confront destructive acting out without knowledge of its origins, they may, paradoxically, increase the level of shame generated from individuals’ inability to change a pattern of behavior they have honestly and mightily struggled to control.


TABLE 1.1 –  Clinical Examples of Reenactment of Trauma

  1. Marrying a “second” alcoholic or someone else who is rejecting.
  2. Physically abusing one’s own child after one has been abused.
  3. Finding oneself in a dangerous situation, such as outside a porn shop in a car alone.
  4. Finding oneself getting romantically involved with a priest again or with someone who is married.
  5. A woman marrying a man who molests her daughter and then remembering her own incestuous relationship with her own father.
  6. Finding work in the emergency room of an inner-city hospital and repeating the chronic and severe chaotic terror in one’s childhood.
  7. Having chronic affairs with strangers, combined with sexual inhibitions with one’s own husband or wife.
  8. Repeating the rape by one’s father or brother through compulsive “tricks” with strangers.
  9. Needing to be beaten or humiliated while having sexual interactions.
  10. Using traumatic sexual fantasies to be aroused or to enable orgasm with a loving partner.

Changing the individuals’ behavior and self-perceptions can be useful even in the absence of knowledge of the past, in some cases. However, the rigid belief that one is always responsible for one’s actions can be, in some instances, extremely inaccurate and potentially destructive. Unconscious reenactments, based on distorted survival strategies, sometimes result in destructive behavior beyond conscious control. Self­ responsibility is possible in such cases following effective psychotherapy that optimally allows the individual to recognize the original function of the symptom and to achieve resolution of the original trauma that had been fueling the prior unconscious enactments.

Physiologic Parallels

The tendency to form repetitive behavior patterns as a result of trauma is more than psychological. Van der Kolk (1989) has reviewed an accumulation of animal and human research, indicating that traumatic stress results in changes in the brain and autonomic nervous system that may mediate and exacerbate a variety of cognitive and behavioral symptoms.

With deregulation of the autonomic nervous system, trauma survivors are incapable of enacting the fight-or-flight response as part of Selye’s (1956) General Alarm System, which leaves them vulnerable to dangerous situations. In addition, they seem to have chronic excessive sympathetic activity, which explains why they often respond to non­emergency situations as if there were a crisis, and indeed sometimes seem to be “crisis generating.” Such research helps explain why medications that block adrenaline, such as clonidine or propranolol, seem to be effective in calming the trauma victim. Van der Kolk (1989) also draws a parallel between trauma victims and the Rhesus monkeys who were stressed experimentally, in early life. Such monkeys later respond violently to amphetamines and chronically drink more alcohol, suggesting a neurobiological link between early trauma and vulnerability to addiction.

Van der Kolk (l989) also has reviewed changes in the central nervous system — in the hyperarousal system — due to chronic alteration in the central neurotransmitter systems. Using the paradigm of response to inescapable shock in animals, he notes that catecholamine depletion is the result of traumatic stress in both humans and animals. This also leads to rational pharmacologic solutions to the use of pharmacologic agents that alter norepinephrine metabolism, such as tricyclics and MAO inhibitors in selected trauma victims. The noradrenergic tracks emanating from the locus coeruleus to the hippocampus and amygdala also play a role in facilitating memory retrieval, which may implicate this system in flashbacks and nightmares of individuals with a history of post-traumatic stress.

Finally, prolonged stress causes analgesia in mice and rats, and similar effects clinically in some trauma victims. This response can be inhibited by the opiate receptor blocker naloxone. This suggests that the analgesic effect of trauma occurring clinically with many veterans and sexual abuse survivors is certainly opiate-mediated. Prolonged stress activities anesthetize receptors in the brain in a manner similar to injection of exogenous opiates such as morphine (Christie & Chester, 1990). Therefore, the self-cutting and other anesthesia frequently demonstrated in survivors can be blocked with opioid antagonists (Braun, personal communication, 1992, and in our own clinical experience) and show cross-tolerance with morphine. It is likely that after exposure to severe stress, re-exposure to traumatic situations in humans can evoke an endogenous opioid response, producing the same effect as a narcotic. Thus it may be possible that such individuals may develop physiologic masochism and may actually become addicted to stress to relieve depression and pain.

Trauma Coding

Trauma coding refers to the control that trauma maintains over survivors, shaping their lives as victims. Primary drives such as the need for nurturance, affection, and genital eroticism are paired with severe abuse and torture, leading to strong and complex double binds that make it difficult to let go of the trauma. Some survivors believe that acknowledging that their caregivers hurt them requires that they have to hate their caregivers and dismiss all positive child memories as distortion. Some survivors need to hold on to their hate because it keeps them bonded tightly to their abusers. Working through the trauma requires that individuals eventually break the trauma coding and free themselves from the rage and hatred that bind them to the people who hurt them in order to be free to create lives that are not organized around the abuse and abusers.


Acknowledging the losses and illusions replete within childhoods filled with neglect and abuse may be more difficult than processing the overt trauma.


On the other hand, many trauma survivors need to hold on to illusions that someone, usually the non-perpetrating parents, really loved them. Otherwise, they become overwhelmed with affect and cognitions that suggest that their lives have been all bad, that they are alone, that any good moments were lies, and that they might as well die. For this reason, they initially attempt to rigidly defend the non-molesting parents as though the parents were the children and they the responsible adults on the scene. Acknowledging the losses and illusions replete within childhoods filled with neglect and abuse maybe more difficult than processing the overt trauma by a given perpetrator.

Table 1.2 lists the components of breaking the trauma coding. Breaking the coding requires accurate, non-distorted memory of childhood and accurate attribution of responsibility for abuse and neglect to those responsible. Adults reexamine and revise their childhood perceptions of the abuse. The core beliefs that derived rationally from the childhood experiences are then reexamined. Finally, the affects that were inhibited or suppressed as children are encouraged and facilitated as a focused process. The result is that adults work through their experiences sufficiently to allow themselves to need neither parental acceptance nor revenge.  Only then are the skills for adult relationships able to be developed and at last, unburdened by transference, emanating from past relationships.


TABLE 1.2  – Breaking the Trauma Coding: Re-empowerment

Breaking the trauma bond requires:

  1. Accurate memory of childhood traumas.
  2. Not distorting the events.
  3. Placing responsibility for abuse and neglect and those responsible.
  4. Using the adult’s reasoning capacity to reexamine and revise the child’s perceptions.
  5. Examining the core belief systems that were established on the basis of the childhood events and making them reality-based with regard to the new perceptions.
  6. Expressing the emotions never expressed as a child.
  7. Expressing the adult emotions of sadness and anger directed at the perpetrators.
  8. Working through the strong emotions to point where one does not want either revenge nor parental acceptance.
  9. Reestablishing a relationship with one’s inner child, on the basis of survivorship and compassion.
  10. Establishing and redefining relationships with adults that are not reactive or similar to early relationships.
  11. Establishing boundaries with others in a non-victim stance, which is based on mutual respect, compassion, and egalitarianism.
  12. Learning tools for healthy expression of intimacy, sensuality, and sexuality.
  13. A female survivor once described several repetitions, including having had her tubes tied at the age 18 for fear of one day, molesting her own child.

As a child, I would lock myself in the bathroom and play with dolls the way I had been touched. One would be in bed, the other would fondle him or her. l couldn’t understand why I did that or where it came from. I was ashamed of this awareness but couldn’t help acting it out. I thought the shame belonged inside me, that the awareness was created solely from me. During my teenage years, I turned to boys to duplicate some of those feelings — of f being cared for or loved. I knew I was fooling myself. I felt the emptiness I was left with after my liaisons with boys, but it was all I had. I was desperate to feel loved. My need for affections was so great, I couldn’t say no to many people and I rarely did.

Do you want to know why I had my tubes tied at age 18? Because whenever I thought of myself around my child, a mental image would always appear. The image was clear, and I believed in its certainty. I saw myself not being able to control the thing that lived in me from you. I saw myself fondling sexually my own infant!

This illustration poignantly conveys the profound fear in adults of internalizing their persecutors and becoming perpetrators themselves. It is frightening to trauma survivors to hear themselves, saying the same abusive phrases said to them to feel themselves capable of the same neglect or abuse that rendered their own childhood a living hell. Some survivors do eventually victimize themselves and/or others in a manner similar to that of their perpetrators. Many survivors’ worst nightmare is that part of the pattern of re-victimization and of trauma coding culminates in their abusing or neglecting their own children.

Silverman, Steele, Droegenuelle, and Silver (1962) noted several decades ago that 100% of batterers were battered in childhood. This repetition is difficult to comprehend without understanding the unconscious reenactment resulting from trauma coding. Some trauma victims also reenact these perpetrations in their sexual fantasies, cementing the erotic, violent connection. Some actually reenact the perpetration outwardly and become victimizers of themselves or others. The result of such shame-producing repetitions is the double-bind belief that they cannot be angry at their aggressors because they are equally bad and have also hurt others. It is imperative that the re-victimization process end, that the victims make amends, and that they learn compassion and self-forgiveness.

lntrojection

All children learn by modeling adults, particularly their parents. Abused children are being told continually that their parents’ affection is conditioned on their performance, which is never sufficient. This creates perfectionistic, self-critical inner voices that berate and criticizes children’s actions; these are the voices of the abusive parents, which have been introjected. Typically, there has been minimal reinforcement for good performance, much less any “unconditional positive regard,” and therefore the self-nurturing and self-appreciating internal messages are nonexistent. When others attempt to provide the latter, there seems to be no internal system to accept such accolades, and therefore individuals tend to avoid or to not hear such strokes and to sabotage their achievements.

This can be a feature of, or coexist with, an even more insidious phenomenon — identification with the aggressor. The abused child can identify with either the aggressive, powerful perpetrator or the weak passive, but usually equally angry partner. Living in a home with continual passive and active rage, the child is like a sponge, absorbing the high levels of resentment. The child will tend to identify with the powerful aggressor, as if to say, “l’ll become like him or her so no one can ever hurt me again. In addition, the child tends to rebel against internalization of the weak parent, who is despised for not protecting the child. The result is the development of thoughts and behaviors similar to the perpetrator, whom the child supposedly hates. One survivor, who was molested in infancy by her father, writes the following to her mother:

“And there is a big part of you in me now. I’m struggling to get rid of it; it is a lot like exorcising a demon — except that the you in me is like an implosion of blackness more than an explosion of rage. Oh yes, when your personality surfaces in me, I become punitive, paranoid, critical, and blaming. All I feel is hate and fear. But when that passes, I’m left with a black hole, devoid of feeling. I’m empty, an emptiness that is palpable and painful. It’s a blackness l can’t describe. It is as if my knowledge and duplication of your horror is robbing me of who I really am. I, the real person, the person who’s been lost for so long, is missing. And sometimes it feels that if I can’t rescue her soon from that void, she’’ll be lost forever.”

In this quote, she is able to articulate powerfully the core of her self-hatred. She despises her mother and despises herself for internalizing and absorbing aspects of her mother.

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