This article was published in dr. rosiello's sedona times psychology column in 2009.
A few years ago, I began treating a very lovely young woman who, after a few months of therapy began a session with a long silence.
She was gathering up the courage to tell her secret. My patient has given me permission to print her story in the hopes that it will encourage other individuals, with a similar secret, to surrender the secret for emotional growth. This particular patient grew up with her mother and younger sister, as her parents had divorced when she was 8 years old. Her grandparents lived a few houses up the street and because her mother worked to support the family, she was sent to the grandparent's home after school. While the grandmother would spend time with both girls, she was emotionally distracted and highly agitated much of the time. So, the grandmother never minded or seemed to notice when the grandfather requested that my patient come into his woodworking shop. She knew what his requests meant and would follow him, aware that if she didn't obey he would threaten to send her away. The grandfather told my patient that her mother was unable to financially support her and her sister without his help. He said that without the grandfather's money, my patient's mother would be forced to send her to an orphanage. As long as my patient did what the grandfather wanted, he would provide financial support to the family.
She said she would follow him downstairs, watch him lower the blinds and then force her to sexually satisfy him. She was 8 years old when it began and it happened for nearly a decade and it happened a few times a month. “You felt there was no way to stop this sexual abuse, no one you could trust to tell?” I asked. She answered, “At first, I was afraid he'd send me away, or that he wouldn't give money to my mother for our support. But after a while, the older that I got, I realized that if I didn't do what he wanted, he might move on to my younger sister. I had to protect her. I didn't want her to do what he forced me to do.”
There are occasions — sometimes long after the patient has left my office that emotional moments from the story linger in the room. This is a beautiful young woman, and she was telling her story of incest for the first time. During that session, she kept looking at me almost surprised at the sadness expressed on my face in relation to her tormented childhood. She had kept this story a secret for nearly a two decades and it seemed as though her years of secrecy had almost normalized her trauma. Her family had no idea that she was incested by her grandfather and as she was growing up she was expected to continue joining the family for holidays. It was a few years ago, that she decided to stop speaking to her grandfather since leaving her hometown. Now, she felt guilt that he was old and she probably was hurting him in not speaking [to him]. This is not an unusual reaction for a sexual abuse survivor. They frequently give up the wish to have their own emotional needs recognized by another person because they have been abused into surrendering to the perverse needs of the victimizer. The victim is attuned to everyone's emotions around them. In a way, this hypervigalence allows them to avoid potential abuses in their adulthood.
About a year later, my patient said she had been looked up online by an old high school boyfriend, and they were going to date again. Within a few months, he asked her to marry him. He had also been sexually abused as a child by an older brother, and my patient felt a kinship to his history. While I was pleased that she would enter a relationship with a caring man, I was also aware that memories of her old boyfriend had protected her from forming intimate relationships with other men she had dated after their breakup. Her adult life had been formed by fear of a man's attentions — too much attention held the possibility of abuse and her need to avoid intrusiveness loomed large.
There is a delicacy to the treatment of an incested patient: They begin their therapy without the ability to trust another person's actions or motivations. Yet, trust is the bedrock of treatment. Therapy must maintain the balance between the patient's secrets held as a child and the emotional safety of the adult patient. The therapist contains the emotions the patient presents about their childhood, and their shame, and incest, and a feared life. The therapist is the prototype relationship where trust is nurtured and mistrust is analyzed within an inch of itself. It is in the analysis of early emotions that the patient realizes the strengths of the adult. For the incest survivor, they begin to feel the strength they had in living through their ordeal, the emotional strength they used as a small child. It isn't just a development of trust toward the therapist that grows, but the patient begins to trust themselves in their ability to live a life without interference of trauma.