Read an Excerpt
FINDING COURAGE TO SPEAK
WOMEN'S SURVIVAL OF CHILD ABUSE
By PAIGE ALISEN
Northeastern University Press
Copyright © 2003
All right reserved.
Trauma, Violence, and Women's Mental Health
i hate feeling at the mercy of my own mind and body, trapped in all
this freakishness, i do not understand how this could happen, was the
abuse really that bad? i am terrified and confused, and deeply ashamed
of what i've become, my old world has forever crumbled and i am left
feeling brutally exposed with all these people living, breathing, and
crawling around inside me. my mind has finally snapped from too many
childhood years filled with violation and trauma.
In the fall of 1998 I voluntarily admitted myself into a psychiatric
unit of a hospital. I had become completely incoherent and utterly
confused about who or where I was. Nothing was familiar to me,
not even my own hands, thoughts, or words. A team of doctors, two
psychiatrists and a psychologist, diagnosed me with clinical depression,
post-traumatic stress disorder (PTSD), and dissociative identity
disorder (DID), or the experience of having multiple personalities. I
have been hospitalized as the result of these conditions three times in
two different psychiatric facilities. The genesis of these conditions is
severe sexual, physical, ritualistic, and psychological abuse beginning
at the age of three and ending in my teens:
- FORCED INTO SILENCE as i choked on the blood and semen,
choked because i could not breathe from the massive flesh in my
mouth, forced into silence because i could not tell another living
soul about it. someone will die, someone will get hurt, no one will
believe me anyway, no matter what i did it still kept happening.
five years old and forced to suck on his dick, burning cold sores,
neck aching, choking for air. my cold sores bled and cracked, scarring
my lips forever, the condition of my lips doesn't just represent
child abuse, my lips are a symbol of male power and dominance;
they are a symbol of oppression, today my lips are an instrument of
power, they reflect my own resistance and a determination to make
my lips, my very body and soul, matter, these beautiful lips speak
loudly and clearly for the millions of people who can't.
My story is the legacy of millions of people who have suffered at
the hands of abusive caretakers. I share my experiences as a way to
explain how and why it is so many adults continue to suffer years after
the abuse has ended. There are countless compelling memoirs and
personal writings by survivors of severe childhood trauma. Such stories
are powerful and necessary because they demonstrate the lengths of
human cruelty and the amazing capacity to cope in the face of it. By
connecting the many testimonies of abuse survivors, including my
own, I demonstrate how it is that our society shapes and fosters the
conditions whereby child abuse can occur. Through understanding
this process, we can begin to address more adequately the many ways
to stop abusive and terrorizing conditions in the lives of millions of
children and adults each year. Child abuse, and the resulting mental
and physical health problems that develop, are a national public health
crisis. Yet public and governmental attention about prevention, intervention,
and treatment remains sorrowfully inadequate. I feel obliged
to share my personal experiences so that others can become more informed,
and outraged as well, about the devastating effects of child
abuse. Such abuse is unspeakable, but it is imperative that these horrifying
stories are spoken.
The State of Women's Mental Health
Women's health, and women's mental health specifically, is a combination
of many factors and influences. Stress, economic factors, relationship
issues, nutrition and exercise, and environmental factors (e.g.,
pollution and noise) all contribute to how mentally and physically
healthy one is. A factor that almost guarantees a negative effect on
anyone's mental health is repetitive and severe childhood abuse.
Childhood abuse can be so severe and traumatic that children develop
serious physical health problems, such as stunted growth of organs and
bones, internal hemorrhaging, damaged reproductive organs, chronic
pains, and developmental deficiencies, problems that can continue to
haunt a person both mentally and physically in adulthood. Mental
health problems are prevalent for child abuse survivors. Women, especially,
spend millions, if not billions, of dollars each year on tranquilizers,
mood stabilizers, antianxiety medications, and sleeping pills.
Much of this medication taking is due to conditions from early childhood
traumatization. The statistics on the condition of women's mental
health are staggering:
Women and girls make up 85 percent to 95 percent of those with
eating disorders, and millions are affected each year.
Women are two to three times more likely than men to have anxiety
Nearly twice as many women as men suffer from major depressive
disorders, and it is estimated that twelve million women are affected
Women make up 75 percent of those diagnosed with borderline
Women make up 90 percent of those diagnosed with dissociative
Collectively, millions of women are treated for psychiatric problems
that can stem from childhood abuses and trauma. Of course, not
everyone who develops these conditions has a history of abuse. However,
research indicates it is a substantial cause.
There are, of course, mental disorders and illnesses where men are
overrepresented, such as schizophrenia, attention deficit hyperactivity
disorder, and autism. Most of these illnesses are organic to the
brain-that is, part of the brain composition. This is very different
from environmentally based disorders, such as dissociative disorders
and eating disorders, which are caused by humans. Acknowledging gender
differences does not imply that boys who are abused do not also
develop serious psychiatric disorders in adulthood. We know, for example,
that 10 percent of those who develop multiple personalities are
abused males. What is important to understand is that as boys grow
up, they become men in a society that is male dominated, whereas
females continue to face sexism as they grow older. Both the causes
and consequences of abuse can be markedly different depending on
Abuse occurs in many types of relationships, i.e., in heterosexual
and same-sex relationships, between and against elders, and between
people who don't live together. There is something markedly distinct
about abuses perpetrated against females in heterosexual relationships
that differentiates this type of abuse from others. In other words, research
demonstrates over and over again that violence against females
is systematic and profound. Systematic means the abuse is intentionally
and purposively directed at females; it happens because we are
female. In chapter 4, I provide an in-depth discussion on this point.
For now, understand that there are systematic ways in which females
are treated and violated by virtue of the fact that they are female. For
example, girls are vulnerable to sexual assault and are three to five
times more likely than boys to be targets of sexual violence. In the
most extreme cases of sexual abuse, people develop severe trauma-related
disorders in order to survive. It is understandable, then, why
females make up the majority of those who suffer from mental disorders
caused by childhood traumatization: they are most often the victims
of abuses that commonly lead to long-term problems. In analyzing
abuse this way, we can better understand why so many adult
women have psychological problems from extreme abuses experienced
Throughout this book, I focus on two serious mental disorders
based in traumatization: post-traumatic stress disorder and dissociative
identity disorder. Most of us equate PTSD with military veterans, yet
the primary cause for developing post-traumatic stress is childhood
abuse, domestic violence, and rape (including spousal rape). Seventy
percent of the approximately 5.2 million people living with PTSD are
women. An estimated 1 percent of the general population, or 2.8
million people, live with multiple alter personalities. PTSD and DID
are related in that as many as 80 percent to 100 percent of the people
diagnosed with DID have a secondary diagnosis of PTSD. Dissociative
identity disorder, more than any other disorder, is caused almost exclusively
by severe child abuse and human cruelty. Ninety-eight percent of
the documented cases of DID have histories of extreme child abuse.
Additionally, 5 percent to 20 percent of the patients residing in psychiatric
hospitals are thought to have DID. Studies in more than
twenty countries around the world indicate a similar prevalence of
DID in both clinical and nonclinical samples. In other words, multiple
personality is not just a condition occurring in the U.S. Multiplicity,
or the experience of living with multiple alter personalities, is
much more common than most of us realize. Mental health experts
now consider dissociative identity disorder to be a very serious public
health problem, yet it has failed to gain proper medical, public, and
Sitting with other women in a psychiatric hospital, I couldn't help
but think of the many people suffering with severe trauma-related
disorders. How many were unable to receive the kind of care I received?
What happened to the people who didn't have adequate support
or the resources to find help? And how in the world could a
society allow this kind of abuse to happen in the first place? Dissociative
identity disorder is the manifestation of human cruelty. It is a
condition that could be virtually eliminated if not for the infliction of
severe child abuse. By learning more about DID, we can understand
better how and why it is children are so easily tortured and abused in
What Is Dissociative Identity Disorder?
Under extreme traumatic conditions, many people learn to mentally
dissociate as a way to escape the trauma. In other words, when
people are unable to flee traumatic events physically, they escape mentally.
Dissociation causes a person to disconnect mentally from the
experience or feelings as if she weren't there. A dissociator can act as a
spectator to her own beatings and rapes, watch from the ceiling, or
meld into the walls, as if the abuse were happening to someone else.
Such dissociative strategies can become extreme and happen not only
during threatening situations but in nonthreatening conditions as
well. While this coping strategy may have been beneficial and even
lifesaving in childhood, severe dissociation can begin to impede adult
life. Dissociative identity disorder is the most extreme form of dissociation
and a serious psychiatric disorder whereby a person develops two
or more separate and distinct personality states, also referred to as
alters, alter personalities, or identities. Frequently absent from consciousness,
alters can control a person's thoughts, feelings, and behaviors
at different times and in different ways.
The splitting off of consciousness to the point of developing separate
alter personalities happens due to extreme and often brutal conditions.
In chapter 3, I discuss more thoroughly how multiple alter personalities
develop and are experienced. In the most basic sense, alters
are created unconsciously out of terror and desperate survival. Sue
William Silverman describes what it is like to lose consciousness while
another personality takes over. For her it meant disappearing in a bubble
of water while an alter personality, Dina, emerged.
Concentrate on the bubbles of water. They make soft explosions
as they crash against the surface, but then another rise rise rises
out the roof of my head. But the room is still, yes. I am. My legs
are paralyzed. My arms are useless. I am bloated with hot, heavy
water, yet weightless, too: here, not here. I am opposites at the
same time. And from the distance of my bubble my hazel eyes
watch my daddy stick his finger inside Dina, telling her, whispering
to her how much he loves her-me-us, loves her-me-us, with
a love that is everlasting and true.
Silverman feels her body yet simultaneously watches from a distance.
She was able to create a bubble of safety for herself, but in doing so,
another more able being was created. When people split off repeatedly
to such extremes, separate identities can result.
The dissociative experience is different for each person, but the creation
of new alters happens for similar reasons: the person is unable to
handle an extremely terrifying event. Laurie was a survivor of horrific
childhood abuse and hospitalized for multiple personalities. She recalls
about her mother:
Her anger terrified me. So what I did was set up in my mind a
kind of perfect non-angry happy Laurie. I could meet my mother's
expectations by not getting myself agitated or upset. It was
an ingenious solution. I never told her when I felt bad; I never
asked for any comfort. If I hid my feelings by literally forcing
myself to believe I wasn't upset or angry, then I wouldn't bother
my mother. Nor would I need her warmth, affection, care. I
handled it alone, tearing out of myself the hurt and storing it up
somewhere inside where it wouldn't affect me. I learned how to
make myself invisible.
Laurie's invisibility became so extreme that she developed an alter personality
to deal with her mother's anger. The rest of her being worked
its way deeper and deeper into unconsciousness to stay protected. For
most of us, the separation of alters happens without our knowledge; it
is completely unconscious.
People who develop alter personalities have had extreme, tortuous
childhoods. Ninety-eight percent of the individuals diagnosed with
DID have documented histories of "repetitive, overwhelming, and
often life-threatening trauma at a sensitive developmental stage of
childhood (usually before the age of 9)." In other words, DID does
not develop in a child because of a one-time upsetting event, however
catastrophic it may be. The trauma is repetitive. Sixty-eight percent of
those diagnosed with DID have histories of severe childhood incest.
The majority of people diagnosed with multiple personalities report
being victims of father-daughter incest. An incest survivor myself, I
wrote the following description fifteen years ago. It is a memory I have
had since childhood.
- IT WAS NIGHTTIME and I was sleeping in my crib. It was very
dark in the bedroom and my father came to check if I had wet the
bed. I woke up and remember feeling like he shouldn't be checking
on me because I didn't wet the bed anymore. I kept my eyes closed
and pretended I was asleep.
Excerpted from FINDING COURAGE TO SPEAK
by PAIGE ALISEN
Copyright © 2003 by Paige Alisen.
Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.