Denial

“The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma. People who have survived atrocities often tell their stories in a highly emotional, contradictory, and fragmented manner that undermines their credibility and thereby serves the twin imperatives of truth-telling and secrecy. When the truth is finally recognized, survivors can begin their recovery. But far too often secrecy prevails, and the story of the traumatic event surfaces not as a verbal narrative but as a symptom.”

~Judith Lewis Herman, M.D. Trauma and Recovery: The Aftermath of Violence — From Domestic Abuse to Political Terror

A couple of weeks ago, before we were practicing social distancing, I was at a major event along with a large number of people I didn’t know. During a conversation with a new acquaintance I was asked the inevitable question: “So, what do you do?”

I didn’t (and still don’t) have an easy answer for that question.

Several thoughts went through my mind. Do I tell her that I’m a psychiatrist, but that I’m not practicing? Do I tell her that my license was recently revoked? Do I explain why? Do I forget about all that and tell her that I’m doing a lot of yoga? That I’m writing? That I’m recovering from trauma? As I ran through the options in my mind, an easy way to respond to her question eluded me.

I decided to risk telling her some of my story.

I’d only just gotten started when the woman looked at me with surprise. “Oh my gosh!” she said. “I know your story! I heard you interviewed on the radio a few weeks ago!” She went on to say that she had the impression that there was much more to my situation than what the journalist was able to touch on in the short interview. She was left curious and, now that she had me in front of her, she was interested in hearing the rest. She seemed like a reasonable audience, and I’m always wondering what people think about my story. Do they believe me? Do they think I’m to blame? This was a chance to find out…

So, I began to describe more about my situation and what happened to me. At one point, I told her that I had initially denied that I had any sort of relationship with my abuser. “Yes” she said, remembering that detail from the media coverage, “that didn’t help your case”.

She was right. It didn’t help my credibility that I initially hid the truth that I had been abused, raped, and terrorized by my tormentor who was also my patient. It hasn’t helped some people’s opinions of me, as demonstrated in Facebook comment sections. More importantly, it was all the excuse the College of Physicians and Surgeons of Ontario needed to label me as “deceptive”, and this led to the unravelling of the criminal case against the man who extorted and raped me. He ultimately avoided responsibility for his crimes against me because of that blemish on my credibility.

Here’s the truth, now that I’m in a place where I can tell it: I experienced prolonged psychological, physical, and sexual trauma at the hands of my abuser. He did very similar things to several other women too.

For a long time, though, this was not a truth that I was willing to reveal. Like many trauma victims I kept the abuse I experienced hidden. I didn’t confide in my colleagues, I didn’t tell my family, and I didn’t go to the police. At the time I wasn’t wishing that someone would rescue me, or that the police would arrest him, or that anyone would know what I was going through.

Instead, what I desperately wished was for it to all just go away.

What I didn’t want to do was to have to think about it. I pushed it down as far as I could in order to survive. The denial was so deep that I hid the truth from myself. I simply could not let myself acknowledge what was happening to me, and that meant that I was deeply committed to making sure that I wasn’t challenged by that truth in front of anyone else. The abuse went on for a year before I finally found the courage to escape.

You might imagine that my escape would have brought me some relief, but it didn’t. From everything we know about abuse, it’s clear that severing an abusive relationship places a woman at increased risk of threats, violence, and even death. Her abuser is likely to make efforts to try to regain his control over her.

That was certainly the case for me. My abuser threatened me, stalked me, and did everything he could to bring me back under his power. He had threatened to destroy me, and when he got the College of Physicians and Surgeons of Ontario to accuse me of “sexually abusing” him, I interpreted this as another one of his attacks. Like many abuse victims, I also felt a deep shame that I had been groomed, lured, and raped. I was sure that I was to blame for what he had done to me and certain that I had brought all of it on myself.

I denied everything.

This is a very typical response that I recognize from treating patients who experienced their own trauma. This response is well described in the medical literature and is the subject of considerable research. But being so close, I couldn’t see it in myself at the time.

It is well understood that victims of rape and abuse commonly deny their experiences for all sorts of reasons. Often the abuser still holds the power to hurt his victim physically, psychologically, financially, and through other means. It has been well established that, even when asked directly, many victims of abuse repeatedly deny their experiences. It is common for survivors of rape to take a long time to come forward and many never report their experiences to an authority figure. Shame and fear — combined with the prospect of having to deal with unsupportive and often antagonistic police officers, lawyers, judges, healthcare professionals, and social media — make secrecy preferable to telling the truth. As observed by the internationally-renowned psychiatrist and trauma expert Dr. Judith Herman, “far too often secrecy prevails”.

As I talked with my new acquaintance, I tried to summarize some of this to explain why I initially denied the abuse that I suffered. What I said seemed to resonate with her. She told me a story about someone close to her who had been abused. The abuse remained a secret for quite some time and, when it finally did come to light, the aftermath wasn’t pretty. The victim had good reason to suspect that the truth wouldn’t be well received and to want to keep it hidden. My new acquaintance was witness to the devastating follow-out.

People seldom reveal their darkest stories if they don’t feel safe. Women in or recently escaped from abuse do not feel safe, even if people tell them that they are. Denial can be a way for a victim to hold on to whatever tiny amounts of control she still has left.

As a psychiatrist who has worked with many survivors of trauma, these are facts I know well. As a survivor myself, these are truths that I now know deeply and personally.