The table that follows illustrates Anna's retraumatization by conventionally
accepted psychiatric practices and institutional environments.
| EARLY CHILDHOOD TRAUMA EXPERIENCE |
COMMON MENTAL HEALTH INSTITUTIONAL PRACTICES |
| Unseen, unheard |
| Anna's child psychiatrist did not inquire into or see
signs of sexual trauma. Anna misdiagnosed. |
Adult psychiatry does not inquire into, see signs of or
understand sexual trauma. Anna misdiagnosed. |
| Anna's attempts to tell parents, other adults, met with
denial and silencing. |
Reports of past and present abuse ignored, disbelieved,
discredited. Interpreted as delusional. Silenced. |
| Only two grade school psychologists saw trauma. Their
insight ignored by parents. |
Only two psychologists saw trauma as etiology. Their
insight ignored by psychiatric system. |
| Secrecy: those who knew of abuse did not tell. Priority
was to protect self, family relationships, reputations. |
Institutional secretiveness replicates family's.
Priority is to protect institution, jobs, reputations. Patient abuse not
reported up line; public scrutiny not allowed. |
| Perpetrator retaliation if abuse revealed. |
Patient or staff reporting of abuse is retaliated
against. |
| Abuse occurred at pre-verbal age. No one saw the sexual
trauma expressed in her childhood artwork. |
No one saw the sexual trauma expressed in her adult
artwork with the exception of one art therapist. |
| Trapped |
| Unable to escape perpetrator's abuse. Dependent as
child on family caregivers. |
Unable to escape institutional abuse. Locked up. Kept
dependent: denied education and skill development. |
| Sexually violated |
| Abuser stripped Anna, pulled T-shirt over her head. |
Stripped of clothing when secluded or restrained, often
by or in presence of male attendants. |
| Stripped by abuser to "with nothing on below." |
To inject with medication, patient's pants pulled down
exposing buttocks and thighs, often by male attendants. |
| "Tied up," held down, arms and hands bound. |
"Take down," "restraints"; arms and legs shackled to
bed. |
| Abuser "blindfolded me with my little T-shirt." |
Cloth would be thrown over Anna's face if she spat or
screamed while strapped down in restraints. |
| Abuser "opened my legs." |
Forced four-point restraint in spread-eagle position. |
| Abuser "was examining and putting things in me." |
Medication injected into her body against her will. |
| Boundaries violated. Exposed. No privacy. |
No privacy from patients or staff. No boundaries. |
| Isolated |
| Taken by abuser to places hidden from others. |
Forced, often by male attendants, into seclusion room. |
| Isolated in her experience: "Why just me?" |
Separated from community in locked facilities. |
| "I thought I was the only one in the world." |
No recognition of patients' sexual abuse experiences. |
| Blamed and shamed |
| I had "this feeling that I was bad...a bad seed." |
Patients stigmatized as deficient, mentally ill,
worthless. Abusive institutional practices and ugly environments convey
low regard for patients, tear down self-worth. |
| She became the "difficult to handle" child. |
She became a "non-compliant," "treatment-resistant"
difficult-to-handle patient. |
| She was blamed, spanked, confined to her room for her
anger, screams and cries. |
Her rage, terror, screams and cries were often punished
by meds, restraints, loss of "privileges" and seclusion. |
| Controlled |
| Perpetrator had absolute power/control over Anna. |
Institutional staff had absolute power/control over
Anna. |
| Pleas to stop violation were ignored. "It hurt me. I
would cry and he wouldn't stop." |
Pleas and cries to stop abusive treatment, restraint,
seclusion, over-medication, etc. commonly ignored. |
| Expressions of intense feelings, especially anger
directed at parents, were often suppressed. |
Intense feelings, especially anger at those with more
power (all staff), suppressed by medication, isolation, restraint. |
| Unprotected |
| Anna was defenseless against perpetrator abuse. Her
attempts to tell went unheard. There was no safe place for her even in
her own home or room. |
Mental patients defenseless against staff abuse.
Reports disbelieved. No safeguards effectively protect patients.
Personnel policies prevent dismissal of abusive staff. |
| Threatened |
| As child, constant threat of being sexually violated. |
As a mental patient, constant threat of being stripped,
thrown into seclusion, restrained, over-medicated. |
| Discredited |
| As a child, Anna's reports of sexual assault were
unheard, minimized or silenced. |
As a mental patient, Anna's reports of sexual assault
were not believed. Reports of child sexual abuse were ignored. |
| Crazy-making |
| Appropriate anger at sexual abuse seen as something
wrong with Anna. Abuse continued--unseen. |
Appropriate anger at abusive institutional practices
judged pathological. Met with continuation of practices. |
| Anna's fear from threat of being abused was not
understood. Abuse continued--unseen. |
Fear of abusive and threatening institutional behavior
is labeled "paranoia" by the institution producing it. |
| Sexual abuse unseen or silenced. Message: "You did not
experience what you experienced." |
Psychiatric denial of sexual abuse. Message to patient:
"You did not experience what you experienced." |
| Betrayed |
| Anna violated by trusted caretakers and relatives.
Disciplinary interventions were "for her own good." |
Anna retraumatized by helping professional/psychiatry;
interventions presented as "for the good of the patient." |
| Family relationships fragmented by separation, divorce.
Anna had no one to trust and depend on. |
Relationships of trust get arbitrarily disrupted based
on needs of system. No continuity of care or caregiver. |
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