Book review – Susan Henry (director The Delphi Centre)

Book Review: Innocence Revisited: a tale in parts.
Author: Dr Cathy Kezelman.

This book is written by Dr Cathy Kezelman, a trained medical practitioner, the mother of 4 children, chairperson of Adults Surviving Child Abuse and director of the Mental Health Coordinating Council. It is Cathy’s invaluable account of rising to the challenge of addressing emerging memories of child sexual and organized sadistic abuse triggered by the death of her beloved niece in a car accident.

Cathy writes beautifully – which helps in recounting a story of such agony and cruelty. As Mark Tedeschi, QC, Senior Crown Prosecutor, NSW says ofthe book “it does happen … in every segment of our society …. from family friends and family members”.

Cathy is skilled at portraying the complex reactions to trauma as a child struggles to know and feel, at the same time as to not, in an effort to maintain crucial attachment bonds and create the illusion of safety to endure the abuse. Her account is easy to read despite the horrific abuse. She describes the emergence of ever more overwhelming material yet it is not a sensationalized account. Cathy responsibly and gently touches
on often ignored or denied issues such as the re-enactment of abuse (eg. with her doll) as well as the ultimate victimization in setting up a child to victimize. The final chapter includes important material about the nature and complexities of memory and related issues to healing from severe abuse, torture and overwhelming trauma.

The courage, sensitivity, responsible consideration of issues and willingness to put her story out there is to be commended. It is an important account that will benefit therapists and related professionals such as legal and policy makers. It will also aid clients when at a point in their healing where the accounts of others may be beneficial.

Psychologists, psychiatrists, counsellors and related mental health professionals still do not receive adequate under-graduate training in identifying or responding to psychological trauma. Typically, inexperience in identifying trauma reactions leads to misdiagnoses or a belief that dissociative disorders are rare or confabulated. Therapists may also feel deskilled or succumb to concern about being professionally ostracized in the face of recognizing the reality of a person’s suffering and the causes.

Cathy was fortunate to find a therapist with an open heart and mind who did not merely medicate or pathologize her but who appreciated that her psyche and body would let her story unfold given a chance. She had faith in the process of healing. Like most trauma therapists, she no doubt found herself on a steep learning curve and would do some things differently now. I mention this because I imagine that both
therapists inexperienced with complex dissociative reactions, as well as clients beginning, or contemplating their journey in therapy may be concerned or confused by some of what Cathy outlines.

While every client’s path, and every therapist’s style and approach, is unique, principles of effective, compassionate therapy for dissociative disorders have evolved over a couple of decades from experience worldwide. The International Society for the Study of Trauma and Dissociation provides ethical guidelines based on this. Different from Cathy’s early experience in therapy the ISSTD recommends no more  than two, ninety-minute sessions a week. Weekly sessions are typically enough. On occasion, where some clients may benefit from brief hospitalization, specialized units such as the Trauma and Dissociation Unit at Belmont Private Hospital in Qld can avoid compounding problems due to medical and nursing staff being unfamiliar with trauma dynamics and dissociative responses.

Principles of healing from trauma (such as outlined by Briere and Scott; Ross and Halpem) underpin effective strategies for helping clients navigate boundaries, ground flashbacks, place the locus on control with him/herself, and safely pace work around abuse dynamics as well as process deep emotion. Clients do the challenging work of therapy best when supported to manage a career or job, cope with a family and engage
in a social life and be a contributing member of society. Healing is not faster or better by focusing time and energy primarily on therapy. Being consumed by it actually makes it harder. Decompensation is more likely. Perceived lack of choice and control is disempowering and re-enacts the trauma.

Powerful feelings are brought up in the therapist. Even the most experienced and competent can easily find that without case consultations and ongoing professional development to address the vicarious traumatization and counter-transference, as well as enhance effective therapeutic strategies, it can impinge on therapy and therapist self-care. Without this, it is easy to respond to what the client may intensely but erroneously believe he or she needs in the midst of often excruciating distress and complex defense mechanisms.

Cathy’s book is a rare, well-crafted, one. She elucidates the terrible impact of child abuse and the long term consequences that we as individuals in society, not just therapists and academics, have a responsibility to address. It is also an account of hope and inspiration; the power of truth.

Susan Henry

The Delphi Centre

Professional Development Training and Counselling Services
Melbourne

Ref:

Briere, J., & Scott, C. (2006). Principles of trauma therapy: A guide to symptoms,
evaluation, and treatment. Thousand Oaks, CA: Sage Publications.

Ross, C. & Halpern, N. (2009). Trauma Model Therapy: A Treatment Approach for
Trauma, Dissociation and Complex Comorbidity.
Manitou Communications: TX, USA.

It’s time to act to protect those at greatest risk of suicide

It’s time to act to protect those at greatest risk of suicide.

According to the findings of a study announced on April 1 by the Australian Bureau of Statistics, the rate of suicide in Australia is continuing to rise. As Dawn O’Neill CEO of Lifeline Australia states, “This is a whole of community issue. We’re in denial about this as a society.”

Not only is our society in denial about suicide but it is also in denial about the markedly increased risk of suicide amongst those abused as children. Recently we have seen scores of new revelations of child abuse both institutionally and in the private domain. Yet as a society and as communities we still struggle to acknowledge the scale or the gravity of the problem. We still grapple with a pervasive cultural disgust which prevents us from mounting a human response to help, support and protect those victimised as children. By conservative estimates there are more than 2 million Australian adults struggling day-to-day with the impact of having been abused or neglected in childhood. Amongst their many challenges, these adults are at serious risk of suicide and yet nothing is being done to address this risk. Having survived a childhood of fear and torment, being left struggling to survive in adulthood is a travesty.

A Victorian study released in February this year revealed that people sexually abused as children are more than 18 times likely to commit suicide than the general population. An earlier study released in 2001 showed that the rate of suicide for young Australian survivors of child sexual abuse is 10.7 to 13 times those nationally. It is hard to imagine what more information is required for the Government to act.

As chairperson of Adults Surviving Child Abuse (ASCA), the key national organisation working to advance the wellbeing of people and communities affected by child abuse, I am only too aware of the risk of suicide associated with childhood abuse. ASCA loses several people every year either because help is not available or because they do not know how to access it. The number of Australians at risk, and devastatingly who are lost, because of unaddressed childhood issues is staggering.
Having lost a close member of my family to suicide as a result of his child abuse and having been close to taking my own life as a result of being subsumed by the trauma of my childhood I am passionate about seeing these risks addressed.
Another well-researched 2006 study found that childhood abuse and adversity accounted for 50–78 per cent of the risk within the community for drug abuse, depression, alcoholism, and suicide attempts. As adult survivors are 3-5 times more likely to experience a major depressive episode during their life and at markedly increased risk of abusing substances including alcohol and drugs, the suicide risk in this group is compounded. Abuse of substances lowers inhibitions, and impairs judgment, all factors which make people who are already vulnerable more likely to act on suicidal plans. These same factors are also associated with domestic violence and abuse, another factor that increases the likelihood that suicide will occur.

The lived reality of many adult survivors of childhood is often one of isolation and living on the margins of society, with the disadvantage seeded in childhood compounded due to its impacts. Families especially in which the abuse is intra-familial are often disrupted due to divisions which see one part of the family support the survivor and another part ostracise them. Difficulties survivors often have with trust and forming and sustaining relationships compounds the sense of isolation and lack of support. Suicide is indeed a whole of community issue as is addressing the stigma and taboo around child abuse, its legacy and the mental health and social issues which go with it.

A crucial first step in turning these issues around would be the development of community awareness and stigma-reduction campaigns in relation to the link between child abuse and mental illness/suicide coupled with mental health promotion initiatives.

Across Australia there has been a systemic failure to provide appropriate trauma-informed services to the majority of those needing them. This has been compounded by a failure to translate advances in trauma research into education and practice. The composite failures in service provision and expertise, as well as in access and equity significantly exacerbate the risk of suicide in adult survivors of childhood trauma. Information on the psychological impacts of abuse and trauma and tools to help address them must be introduced nationally into core mental health training and curricula as a priority. Responsive and effective crisis management must be matched by affordable accessible ongoing care so that the core issues of abuse, which directly contribute to increased risk of suicide, are adequately addressed.

Not only do we need to see widespread education and training within generalist services and the expansion of specialist services but there must be a comprehensive improvement in referral pathways, including direct access to community-based services. Affordability issues also need to be addressed as the impacts of childhood abuse on education and work prospects often restrict the capacity of adult survivors to access services, even when they are available. Private services are often unaffordable and the provision of therapeutic services through the MBS scheme for trauma survivors, while a start, are generally grossly inadequate given the long-term care and support needed by the majority of these clients.

Since 1995 ASCA has offered life-affirming services to thousands of adults who have suffered sexual, emotional and/or physical abuse and neglect in childhood. ASCA’s 1300-line and psycho-educational workshops save lives. Yet ASCA receives no ongoing government funding. This year, as these new statistics are released, ASCA’s workshop program has been effectively shut down and its 1300-line is now under threat. These services are the only ones of this kind in Australia. Without them Australian adult survivors of child abuse will be more isolated and bereft, and even less able to access the help and support they need to survive in adulthood.

In this election year when we are called upon to decide which government we should support, the government needs to understand that there is a large cohort of adult survivors in the community whose needs are not being met and whose risk of suicide is substantial. As a community we need to look after our most vulnerable and protect those whose childhoods betrayed them and whose adult lives are at serious risk.

The ongoing protection of children must be a priority

 

This article was posted online in response to an article on eureka.com.au about the crisis in the Catholic Church entitled “Yes we can beat church abuse”

An apology while welcome is only a start and for many sadly is too little too late. The fundamental betrayal of victims by the perpetrators has been serially compounded by the systemic failures of the institution and its hierarchy to act. We have seen global cover-ups, institutional risk minimisation, failure to bring the perpetrators to civil justice, blaming and re-victimisation of the victims and a failure of pastoral care.

Apologies are needed but they must be matched by a genuine focus on ongoing care and support for victims, reparation, true accountability, real justice, and a structural review of the factors which have enabled secrecy and silence to take precedence over the spiritual and physical wellbeing of the flock. The ongoing protection of children must be a priority with every measure being taken to ensure not one more innocent child is put at risk. The damage done to the innocents amongst us has been devastating. The victims who have been left struggling, their communities and families must be the focus.

An apology yes but real redress and a review and fundamental changes within the institution which allowed so many crimes to be committed within its walls.

Love, warmth and support

Thank you for wrting Innocence Revisited – a tale in parts. I read your book in one sitting, not wanting to leave you in your struggle for one minute. I wanted to reach out to you with an outpouring of love and acknowledgment of your life.

Not knowing how to do this effectively I humbly wrote these words in the hope that they could add to your strength and resolve to allow the healing force within you to thrive. A force that allows you to discover love and support intenrally, externally and eternally.

Thank you for your survival, courage and determination,. whilst I can’t begin to comprehend the depths of your suffering I recognise the importance of us moving beyond our hell. Hopefully with this telling of your story, Cathy more of us can emulate you and be a positive force in this world.

I honour you, your integrated self

With love R.

ABC coverage

 

Author Dr. Cathy Kezelman

 
Date/Time posted  Four Corners guestbook 07/04  
Subject Four Corners program – “Over the edge”  

 

It is of serious concern that the ABC both in Catalyst and now Four Corners has over the last month presented a one-sided view regarding the issue of recovered memories/false memories.

There is evidence for both the existence of recovered memories and false memories. They are not mutually exclusive i.e. the existence of one does not negate the existence of the other.

The last 20 years has seen a lot of research in the area of trauma and the way in which traumatic memories and encoded and stored. And delayed recall of memory occurs across all sorts of trauma.

Studies have also shown that recovered memory for trauma has virtually exactly the same level of accuracy as continuous memory for trauma.

Studies also have shown that a substantial proportion of those who recover memories do so without being in therapy of any sort, and that when people recover memories when they are in therapy, most often the memories are recalled outside of the actual sessions, and without the use of specific memory techniques.

The practices exhibited by the charlatan highlighted in this Four Corners program were appalling and the results devastating. However the fact that the memories which resulted from these approaches were false does not mean that memories of trauma recovered elsewhere are not true.

Dissociation is a well-recognised psychological phenomenon in which there is a disconnection between a person’s thoughts, memories, feelings, actions, or sense of him/herself.

During a traumatic experience such as a natural disaster, accident or crime victimisation dissociation helps a person tolerate the intolerable and so continue to function. Dissociation effectively means that some or all of the memories of the trauma become unavailable to consious recall.

Dissociative (traumatic) amnesia causes gaps in a person’s recall which cannot be dismissed as normal forgetting and these gaps usually correlate with particularly stressful or traumatic periods in one’s life.

When traumatic memories return, usually as a result of a trigger, the sensations, movements and emotions return with a venegeance. Yet there is no narrative, context or time sequence, often leaving a person stuck in aspects of the trauma.

The story of recovered memories also needs to be told. Hopefully the ABC will ensure that it is so a balanced view is available to its viewers.

Dateline – interview with Fr. Tom Doyle

 

Dateline showed an interview with Fr Tom Doyle who has been observing the impact of child abuse within the catholic Church for 25 years. He is outspoken about the systemic failure of the church to act. I posted the following comment on the website

Fr. Tom Doyle speaks the truth – systemic failure

The RCC continues to fail to bring the perpetrators of child sexual assault to justice, address the systemic secrecy and silence within, or provide the requisite pastoral care to victims. Crimes have been committed by clergy globally and yet the church hierarchy has repeatedly failed to take responsibility or intervene to protect children. Child abuse is a pervasive social practice, not limited to RCC but the response of this institution has exponentially comounded the damage.

COURAGE UNDER FIRE!!!

Dear Cathy,
I finished your book on Monday morning, I couldn’t put it down. Such COURAGE UNDER FIRE!!! Tears were streaming down my face in the final pages at your triumph. I had lots of questions on the Sunday because I hadn’t finished the book but these were gradually answered. No one should have to endure what you endured, it’s a credit to you and growly that you all pulled through, he’s the best, doing his absolute most to help you survive and survive you did. You were blessed with Kate, she came through as a very courageous therapist, professional and also your trusted friend.   I read somewhere that at your book launch your children spoke and Dan and that they had the audience in tears, it is a blessing that your family is still together and stronger than ever. Cathy you are an absolute legend in my book, I thank you from the bottom of my heart for your involvement in ASCA, it is the most wonderful organisation and it has given me so so so much strength. You are doing good things, you are helping so many people, this book is going global girl look out !! 🙂 love Frances x