In Songs for the Forgotten: A Psychiatrist’s Record, I take you into the world of White Pines, a three hundred child welfare agency, where we will listen to patient’s stories of trauma and by listening and believing, create healing and wholeness. I weave my own story in with those of my patients, showing how I came to struggle with God. This memoir is my journal of rupture and return:
I sing a song for the abused child, the song no one wants to hear.
I sing a song learned from a lifetime of listening
as a child psychiatrist and as a patient in therapy—
discerning fact from fiction, thoughts from emotions.
I hope you will listen and learn for it is the song of a child left alone.
Who will feed her? Who will care?
I know that song, and it is a song I’ll gladly sing for the children.
Children rarely accuse a caretaker, family member or friend of abuse. Instead, when they act out in the school setting, a psychiatric evaluation is ordered. Marilyn was one child who exhibited symptoms of aggression and sexual acting out. During her psychiatric evaluation, Marilyn had drawn eight pictures of herself, effectively giving a visual representation of her multiple personalities. One was an elegant, well-dressed woman, another a werewolf, another looked like Cinderella with a broom and dustpan—the characters of her life continued in detail. When I asked her who the people in her drawings were, she calmly stated, “I’m not sure.” She then explained that the elegant lady was “good at sex.” The girl in rags was “good at cleaning. The werewolf comes and protects me when mean men hurt my mom and me.” There were others, but she didn’t know them as well. I knew no of mental illness consistent with the symptoms this young girl was presenting. Having been taught that multiple personality disorder was rarer than schizophrenia, less than 1 percent, I had no idea how often I would see multiples and dissociation in my first year of work.
Suggesting to Dr. Peterson, my mentor, that perhaps this little girl was psychotic, I asked if she needed a major tranquilizer. “What?” Dr. Peterson said, pacing around the conference room table. “If you do that, she will be misdiagnosed and mistreated by physicians for the rest of her life. No, you call her multiple personality disorder, because that’s what she is.”
“But how do you treat that?” I asked. I had not had one lecture on childhood trauma or domestic violence in all my years in training.
He sighed. “The best chance she has is to leave her abusers and live in safety. Over time, she may be able to integrate her multiple selves. Hopefully, she can learn to trust others in non-abusive relationships. Unfortunately, sometimes traumatized children recreate violent relationships and abandonment because it feels familiar. For now, it is critical to manage her symptoms—aggression, inattention, insomnia, and hyperarousal—with medication. Behavioral and educational therapy will be integral in helping her stabilize her rage. Misdiagnosing will not help; it only sets patients up for ineffective treatment through the medical system because anti-psychotics may curb the aggression but will not treat the primary disorder. These children are not psychotic. They dissociate, separating parts of themselves so that they do not go crazy. It’s the abuse they are experiencing that is insane, and so they split it off from their consciousness. It makes no sense to them that the father who feeds them is the father who beats them and has sex with them. Separate parts attend to each demand, allowing them to function. They cannot integrate these abusive experiences. Dissociation is the only way they can live within the family.”
I had a new understanding of childhood trauma and its effects on behavior. Marilyn and I had many sessions discovering how early sexual abuse had cause her to fragment herself, how her aggression was fed by fear. Most sessions were aimed at helping her express her fear and panic before she hit someone or abused herself. Many years later, Marilyn was enrolled in classes at the local community college. She saw an advertisement for my workshop, Moving Through Your Life Stories with Writing and Yoga and attended. In the workshop, participants journal about life experiences and then move into gentle stretching and yoga positions, attempting to move the stories out of the deep muscle tissues. Moving major muscle groups and releasing neurological patterns creates healing as the experiences stored in the emotional center, the amygdala, are rewritten and moved in the hippocampus where it becomes narrative, not terror. Marilyn was working hard to create a childhood for her daughter that she would not need to heal from.
God made us lord over beasts, but a little lower than the angels.
I pondered the truth of the message.
Lord over beasts?
Do they fornicate with their young?
Do they beat, burn, starve, mutilate, and suffocate their loved ones?
Lord, recreate us anew, like the animals we strive to be different from.