Walks and Thoughts

of Michael Simes

An old Man's Tale:



West Vale

Clay House


Cragg Vale



Pecket Well

Luddenden Dean

Jerusalem Farm

Catherine Slack

Stone Chair

It's Just Like Home:

Hong Kong





Marlborough Sounds


Milford Sound



Blue Mountains

Northern Beaches


A City Of Revolution:




Notre Dame

The Adult Legacy Of Childhood Sexual Abuse

Individual Therapy With Adult Mental Health

Referrals Where CSA Is The Key Factor

Dick Agass And Mike Simes

Helen was referred by her GP. She had a history of recurrent depressions and had reached the point where she wanted to 'do something about it' rather than carry on taking pills.

It was an enormous step for Helen to come to see a male worker. She later confessed that she very nearly abandoned the whole idea, and only came to the second session because the worker made some remark in the first one about her being 'worthwhile'. Work then got underway on a weekly basis.

The details ofHelen's childhood abuse emerged slowly and painfully, and only after a great deal of tension had built up in the sessions. Like many abuse victims, Helen had suffered an emotionally deprived upbringing and had always had a very poor relationship with her mother. This woman had such a succession of male companions that for many years Helen was not even sure which one of them was her real father. In her teens she was left to look after her younger brother when her mother went to live abroad. She had blanked out much of her childhood and was left with a legacy of poor self-esteem and chronic unhappiness. Her marriage was a misery, since she had chosen a man who treated her in much the same style as her mother, ignoring her emotional needs and undermining her self-confidence.

The sessions put Helen back in touch with her childhood. This produced such an emotional upheaval that after a few months she was reacting to the worker as though he were responsible for her suffering. She was aware that in some curious way he had come to represent 'father' for her, and she started hinting at painful secrets which gave her good reason to be angry with him. Eventually she was able to talk about the sexual abuse she had suffered around the age of eight from Tom, the most important father-figure of her childhood. It transpired that this abuse had come back to her quite forcefully in a nightmare soon after the beginning of therapy. She felt she had spent the whole night holding something off, and actually woke up with arm-ache. As the work progressed she realised that this 'fending oft' had become her primary mode of relating to other people in general.

As more and more of these buried feelings resurfaced, the work. became tense and difficult. Helen suffered agonies of self-blame for the 'stuck' sessions, feeling (as with the abuse) that it was all her fault. When she reverted to being a trapped and helpless child - at times so agitated that she had to flee the room - the worker began to feel like an abuser himself. At such times he felt there was nothing for it but to sit tight and see it through. As Mollon (1988) remarks: 'The therapist just has to endure being seen as an abuser, and indeed feeling like an abuser, at least for a time'.

There were a number of complicating factors about the original abuse. Cruelly, Tom was the only adult who brought anything good into Helen's life. He had time for her, told her stories and made her laugh. He was the one ray of light in an otherwise dismal childhood. But as well as bringing the best he also brought the worst, violating the natural boundary between them in a way which permanently affected Helen's development. She was caught in a terrible trap, in her own words 'resisting something I wanted but didn't want at the same time'. She recalled going numb and frozen whenever Tom fondled her, dissociating herself in the way that so many victims describe (Gelinas, 1983). Briere and Runtz (1988) observe that this 'going away' defence, which serves such a vital purpose at the time of the abuse, can often be generalised maladaptively to other anxiety-provoking experiences. This accurately describes what happened in all Helen's social relationships. For the most part she simply 'wasn't there'.

The final complication was Tom's sudden, unexpected death. Helen recalled her mother's grief and the total chaos to which their family life reverted. She was left with a crushing burden of sadness, anger and guilt, and with no-one to turn to for help.

Not surprisingly the unresolved issues relating to Tom were still being acted out in Helen's adult relationships with men. At one point she advertised for a male companion, and when it came to choosing between a 'safe' candidate and a riskier one she chose the path of risk. She then embarked on a striking replay of abusive themes with a chosen partner who even had the same build and colouring as Tom. As with Tom the relationship began playfully but became more and more oppressive. Her feelings in this relationship made it quite clear that she was re-enacting the earlier situation. For example, the man insisted to her that any problems between them were her fault. She knew she wanted rid of him but feared that life without him would be worse. In one session she even said she felt paralysed, unable to get rid of him because it would be cruel to 'kill him off. Here was a clear indication that for Helen as a child Tom's death had added a cruel twist to the abuse: it had left her believing at some level that her anger had killed him. This conviction later surfaced in a close relationship with another man when Helen became frightened that he would die.

After much exploration Helen was able to see what was happening in the 'risky' relationship and to end it. It seemed as though this re-enactment had in some way helped her to unfreeze the childhood experience and begin to resolve it. Perhaps the vital new element was that she could at last do this in the presence of a trusted parental figure who could provide the help she was unable to get as a child. In classic psychodynamic terms Helen was able to re-live the repressed trauma and make sense of it with someone who not only believed her but also helped her to put the experience into words (cf. Spurling, 1988). In this way she could begin to free herself from the unconscious compulsion to repeat it (Freud, 1914; cf. Miller, 1985, p.162).

When the sessions came to an end Helen was still experiencing problems in close relationships, but her life was much more open and self-directed than it had ever been before. Like so many victims, Helen had been left feeling 'stupid': rejecting the knowledge of abuse by a trusted adult had meant throwing out other learning too (Sinason, 1988). Now her capacity to make sense of her experience and to communicate (both with herself and others) had improved dramatically. As far as the abuse itself was concerned, she reported a dream which seemed to reflect the current state of her internal processing of it. She dreamed of a dead man and a dead child moulded together in clay. She was cutting them with a spade, producing neat clay slices which could be made into something else. The worker took this to mean that the part of Helen which had died with Tom (note their union in the clay) was now available to be fashioned into something new. It was even possible for her to relate to him with a certain controlled aggression (neatly slicing with the spade) for what he had done.

After reading the above account, Helen wrote to the worker: 'It is not clear to me whether you knew that from the first moment we met you were communicating with the 'dead child'. She that died had hardly lived before, due to all the other factors preceding the sexual complication. The main reason I mention this is that 'improved dramatically' doesn't quite convey the intensity of the dramatic journey I have made, almost manages to minimise your/our achievement'.