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Gift From Within - Questions & Answers with Frank Ochberg on PTSD

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Questions & Answers
Joyce Boaz & Dr. Frank Ochberg

Read "Survivor Psalm" by Frank Ochberg

Childhood Survivors and Being a Parent

Q: Dear Frank, Thank you for sending me Michael's letter to you.

 He writes, "Question, have you ever come across articles about childhood survivors of sexual abuse/assault, who stuffed that down inside? And yet, could openly acknowledge the emotional and physical abuse that went on in the family home, but almost like in denial, dissociation, repressed, etc....And these folks then became parents themselves, loving, caring parents, and yet, would visit their perpetrators while also having their own children with them, exposing them to possible abuse from their grandparent[s].  I'm one of those parents [and my ex-wife]; for myself, I always felt the memories, the images I did remember of the sexual abuse were just the mindset of a perverse imagination, & I was always blaming myself. At age 39, came the onslaught of PTSD and nonstop flashbacks...from that point forward I cut off all communication with my abusers, but I feel such guilt for having exposed my own children to their abusive grandparents prior to the ages of 39.   Thanks & take care, Mike"

A: Dear Mike,

I have enormous respect for you, Mike, for your candor, your willingness to share honest and intimate feelings, and for your protection of your children.  I'm not aware of articles by trauma professionals that explain and expand on all the issues you raise, but I do have patients dealing with similar situations and similar concerns.  I'll do my best to respond to you  - and to cover related issues that Gift From Within readers might be facing.

First, let's cover that fog you describe so well...."almost in denial, dissociation, repressed, etc."   This happens frequently.  In fact, we now are required to look for these conditions and add them to the PTSD diagnosis.  We must state whether the PTSD condition includes "dissociative features."  It makes an important difference to know whether the survivor of trauma (any trauma - it could be childhood sexual abuse or it could be a terrible car crash or military combat) - whether that survivor is frequently in an altered state, detached from a clear sense of his or her surroundings and also from a clear memory of what occurred. Among patients I have come to know well, this happens to a minor extent frequently, but not so often to a major and prolonged extent.  In many instances it provides some relief.  But it also delays and complicates progress.  You want to be clear about abuse and abusers so that you can protect yourself and others.  So I hope you won't blame yourself for having had PTSD with dissociative features  (That's the way I'd put it in a diagnostic report).  I'd add that you no longer have those dissociative features.  In fact, you probably don't have full blown PTSD.  And can we start calling it PTSI?  I'm on a campaign to change the name to PTS Injury because that is what it is - an injury that can be seen in modern brain imagery, that eventually heals, and that should be honorable, not stigmatized.

You did what most parents would do, Mike.  You took your new family to meet members of your old family.  Even if you had clear memories of your own childhood abuse, you might find yourself unable to avoid encounters with relatives, including those who were abusive.  The pressure to maintain family contact is enormous.  I don't know any statistics on how often these contacts occur, but it is quite common.  Joyce knows that I have written prescriptions saying "You Don't Need to Go Home Again" for my patients who feel pressure but do not want to see that family member who abused them.  I want to make it clear that you had every right to visit when you did and every right to NOT visit now that you choose to avoid contact.  If you experience shame or guilt for previous visits that may possibly have risked harm to your children, I say, "Good for that shame or guilt."  It is OK.  It means you have a conscience and you will be conscientious.

Be strong enough to carry the burden of guilt.  Some people try to argue us out of guilt or shame.  If the feelings are crushing, I'd try to find a way to bring those feelings down a notch.  But I've learned to honor the self-criticism that my PTSI patients carry rather than to minimize or trivialize it.  At any rate, talking about it and realizing that it makes sense is part of PTSI awareness.

Were your kids abused by your abusers?  That is an important question. Finding the answer to that question is a challenge.  You don't want to create a problem that doesn't exist.  Kids feed off the feelings of their parents.  If you are alarmed, they can become alarmed.  If you can explain your concerns in a loving way, you may find out what you fear but you may also be reassured that no harm has been done.  And if you do confirm a fear, you can handle it in a very wise way.  I'm not going to go into that now, but as you might imagine, it involves demonstrating that you believe your child, that you stand by your child, and that you are not going to lose your self-control.  Children do not want parents to take extreme action against a perpetrator and risk a prison term. (At least, that is the most common concern).

Child abuse within the family, particularly sexual abuse, is destructive because it does create estrangement between the normal, loving family members.  The perpetrator convinces the child that the child will not be believed, will be punished, and is responsible for the abuse.  Incest itself, the physical sexual act, is painful and humiliating. But the injury to family trust is the greater wound.

Mike, from the words and the tone of your letter to Joyce, your family bond with your children is healthy and strong.  I encourage you to focus on that rather than on something that might or might not have happened in the past.  And when the time is right, let your kids know what you experienced as a child.  Let them know that you can experience shame.  Shame is human.

Shame shouldn't silence us.  We need not be ashamed of experiencing shame.  It means we have a conscience.


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