I’m still at the beach exploring my sabbatical. Looking under my bed, I found a rather large stack of paintings from long ago. As you can surmise from my writing, my creativity seems to incorporate my love for my own children and the respect and honor I feel for my pediatric patients. Three of the paintings depict a child who suffered chronic trauma and as a coping mechanism displayed dissociation. Dissociation is simply a separation of the self from reality because some life threatening danger repeatedly causes such fright that the only way to respond is to place it outside the self. As I tell my patients, “You wanted to walk away physically but since you couldn’t, you walked away mentally. Just left the room but inside your mind.” Believe me they get it and so do I now. I didn’t at first but it didn’t take long. The same stories repeating themselves over and over with a unique cast of characters in each telling.
“I’m afraid to go to sleep. I’m afraid I might die.” “Die or be killed?” I wondered but not out loud again. I must have been doing an Initial Psychiatric Evaluation when he drew two pictures of himself. One person carried a“T” on his shirt. The other an “S.” They wore funny little hats. One had feet and the other did not. The one with feet had muscles, biceps and triceps kinda like Superman. He told me “they live inside this place that has computers and they live inside my mind. They like to stay in me because they want to do me first. I don’t know why. They don’t like to be here (outside talking to the Doctor) because they only like the people of the mind.” And that was the middle of my introduction to dissociation and identity disturbances of children with chronic trauma.
What happened to this beautiful child to create the split, this separation of the good from bad, the rage that he created at school and home when he spit back at the world the abuse he had swallowed? So fragmented from the trauma that he had to split himself in two, disavowing the experience that birthed the “people of the mind.” Disavowing the tragedy of his night so he could attempt to function during his day. “Dear God, hear our plea, our prayer to lift up the life of this child. Let us talk to the people of the mind and unite them, give him control over his impulses, both sexual and aggressive so that he can have a life. Hear us, Lord, we are begging you this time not to turn away.” There were days then that I can tell you I was sure He had turned away from us forever and was never turning back. Not knowing where He had gone, I grieved. So did my children.
“Dr. Burns, I’m afraid to got to sleep because I am afraid I will die. Does that ever happen to you?” And I have to answer yes, dear, yes it does happen to me too because now I have listened to your stories for so long that I can not sleep either. Not so much afraid if I sleep that I will die but that you will. And that what should have been done for you is left undone. Please don’t die so I can sleep, I wonder but never out loud.
We want you to listen too. What will come of this? The telling and the listening? One can not know but stories are meant to be repeated. Challenged, changed, charged, dropped and twisted, rearranged but always to be repeated. That is what we are going to do. Are you there? Can you hear us?
Patients described in these stories are made up by Dr. Burns and are based on her experiences of working with traumatized children over twenty years. Any similarities to specific patients are conincidental.