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.