survivors eventually disclose the abuse to people that they trust including relatives,
close friends, family, physicians, and therapists. "Breaking the Silence"
refers to broader disclosure, encompassing complaints to professional bodies,
lawsuits, and public statements, as mentioned earlier -- anything that alerts
the professions and the public to the common occurrence and tragic consequences
of abuse by health professionals.
Breaking the silence is not for everyone, and
it can be personally disastrous or counter-therapeutic. The old adage, "The
best revenge is a good life" depending on the client's needs, may be the
best strategy here.
mentioned earlier, breaking the silence is made difficult by a number of factors,
including survivors' feelings, community attitudes and lack of support, the self-protective
stance of the health professions, and the idiosyncrasies of the legal system.
Dealing with Emotions that Obstruct the Desire to Break the Silence
that obstruct survivors' desire to break the silence include shame, self-doubt,
and fear. The problems created by the sexual abuse, including pervasive self-doubt
about their own judgment, perceptions, and motives, combine with shame and self-blame
to make a complaint or public disclosure seem impossible. Who wants to confess
publicly that she was duped and used?
Quite rightly, survivors fear the consequences of disclosure. They hear tales of husbands divorcing patient-wives, of children
being taken away, and of their humiliating sexual secrets being made public. Most
survivors are angry with the health professions and reluctant to trust boards
of inquiry and committees that consist of other professionals who work in the
same field. Still struggling with guilt about their own complicity and lingering positive feelings towards the professional, some survivors hesitate to take the
step that may cause the offending health professional pain or even damage his
Ethics - 4 Patterns of "Victim Thinking"
believes that "victim thinking" can be traced to one of the following
four common patterns of thinking that emerge during the actual trauma, during
secondary wounding experiences. Ask yourself if you have observed these four patterns
in your abuse survivors:
The person cannot tolerate mistakes in him or herself or others.
2. Personal difficulties are denied.
3. Black-and-white thinking prevails.
4. Survival tactics are continued.
of the severe damage often sustained by people who are sexually abused by mental
health professionals, the frequency of secondary wounding experiences is high.
Immersed in a desire for revenge or compensation, lacking community and family
support, unable or unwilling to get therapeutic help, still struggling with PTSD
symptoms, they may be unable to transcend the victim identity and unable to get
on with their lives.
Helping Mary through Breaking the Silence
is an example of what I stated to Mary as she was in this "Breaking the Silence"
stage. "There is no such thing as "resolving" your trauma issues and
being "done" with your past. For the truly traumatized, there is no "forgetting" and no amount of therapy or mind-control can protect you
from traumatic memories, feelings, and conflicts coming back into your life. However,
if you have never really attended to the trauma, if your trauma-processing work
has been half-hearted or incomplete, then your present-day life is saddled with
a major burden: the issues from your traumatic past with which you have not dealt.
you haven't spent adequate time dealing with the trauma and are trying to suppress or minimize what happened to you, then you are spending your energy fighting yourself.
If this is the case, it is no wonder that you are exhausted and have little energy
for other people. Most of your energy goes to keeping the trauma in denial or repression and managing your symptoms, so they don't get out of control and cause
an economic or emotional disaster. Essentially, you are spending your time and
strength trying to pretend the trauma never happened, or trying to convince yourself
that it wasn't that important and, of course, you can handle it (and the emotions
and issues that it raised) all by yourself."
Ethics - Allow a Perpetrator to Resume Practice?
breaking the silence, Kenneth Pope states there is a tendency of licensing
boards and bodies to assume that perpetrators can be rehabilitated. Pope suggests
that this "may support a deep and chronic sense of special entitlement among
therapists." In other professions, Pope maintains, sexual offenders would not be allowed to return to their job in contact with the population that they
had abused. Allowing a perpetrator to resume a limited therapy practice, he points
out, such as seeing only male patients, ignores the more fundamental issue of
abusing a position of the balance of power and trust.
draws attention to a case where a psychiatrist was prohibited from treating females,
and stresses that such interventions "do little to address the underlying
failures of self management that characterize patient-clinician sexual contact.
He feels there is a failure to focus on the development of a therapeutic alliance
essential for treatment to proceed... Pope states a concern that a clinician who
cannot be considered competent to treat women should be considered competent to
feels licensing boards need a great deal of education to make them aware that
sexual abuse of clients, like other varieties of sexual assault, is not just about
sex. Other dimensions such as the balance of power differential between mental
health professional and client; the mystique and special entitlement accorded
to health professionals; the breach of trust and fiduciary duty; the lack of caring,
empathy, and concern; as well as other personality and situational factors, are
all involved. I feel if mental health professionals who sexually abuse clients
are allowed to return to practice, they should have a lengthy period of monitoring
and supervision as there is little evidence that rehabilitation plans are effective,
and literature indicates the recidivism rate is high.
What are some feelings an abuse survivor experiences to detour him or her from informing others?
To select and enter your answer go to .