Sam* had an intense stare. She would look at you, eyes unblinking, with an intensity that was unwavering. It was hard not to feel uncomfortable under that gaze—to search for what it was you had said or done that was worthy of such concentrated scrutiny. Perhaps if she hadn’t seemed so intimidating, I would have asked her about her gaze the first time she locked her eyes with mine. But her very presence didn’t invite questions. Her small, but lean and muscular frame matching the hardness in her face; her skin weathered and aged by years of drug and alcohol use and a life full of uncertainty about the most basic needs—shelter, food, money to survive.
As her psychologist, I had been given her medical records before we met. The record outlined in cold, clinical, and dispassionate language the story of a young woman whose life had been shaped by poverty, mental illness, substance abuse, and trauma. A childhood shaped by a father who drank to cope with his own mental illness, and a mother who worked desperately to compensate for the chaos left in his wake. Sometimes, she managed to cover groceries, rent, and basic bills, and sometimes, she did not. Sam’s father left an indelible mark: Sexually and physically abusing her from the time she was three until he died when she was 16. Even his death was inexpungible. One bleak wintry afternoon, Sam and her father had argued. He was drinking, and stumbled out of the house in anger. Sam followed him, yelling at him not to walk into the busy street in front of their house. He staggered into the street, unaware he had stepped into the path of an oncoming truck. He died on the road with Sam at his side.
The next several years, Sam was in and out of residential treatment programs and inpatient hospitals. Anorexia; self-harming behaviors, such as cutting and suicide attempts; and borderline personality disorder were all listed as precipitating factors. Posttraumatic stress disorder was conspicuously missing from the diagnostic list.
Through all of this, she managed to excel academically, catching the attention of her high school English teacher. He spent hours with her researching colleges, filling out applications, and submitting them. She went to a small, liberal arts college several states away and attended for a year before dropping out. Her chart noted financial difficulties and substance use as the cause of her departure.
During the next several years, she drifted in and out of homelessness, with exacerbation of her substance abuse and mental health distress. She worked periodically and was intermittently in stable housing. But she also had multiple ER visits for suicidal behaviors, and detox from drugs and alcohol; and admission to several psychiatric programs to help her maintain her sobriety and manage her symptoms. Her intimate relationships were characterized by psychological, physical, and sexual violence; she experienced acquaintance rape and multiple sexual assaults while she was homeless.
So when I sat across from her during that first meeting, caught in that intense stare, I didn’t know where to begin. What question, what statement could begin a relationship with this woman who had every reason to mistrust me, given all the experiences she had with medical and behavioral health professionals. How could I bridge what seemed like a vast divide between our life experiences?
Over the next two years, the outline presented in her chart faded, and the richness and vibrancy of Sam’s personality filled in. She was an avid reader and a prolific writer. This passion, (bordering on reverence), for words was something we both shared. She loved to share her poems, and I felt privileged to be her first audience for many of them. Sam had an incredible talent for getting jobs in the most interesting organizations—quirky non-profits or startups that seemed doomed from the get go. She would come to sessions bursting with excitement about the job description, then the interview, and finally, the job offer. But she rarely kept those jobs for more than a month or two.
Trauma was an organizing factor in her life: The toxic stress she experienced as a child shaped her difficulties forming relationships, sustaining employment, and maintaining stable housing. These were common themes in our work. Sam’s core beliefs about how unworthy she was of experiencing love, stability, and contentment were deeply rooted in her early experiences of trauma and incredibly hard to shift. And while this work was important to Sam, what she always came back to was that her suffering—the very experiences that sometimes brought me to tears when she described them—was not only about her difficulties. She described it also as the source of her greatest strength, creativity, and indefatigable hope
When I slipped one day and let some of my negative feelings about her father show, (a man who I had demonized in my mind for all the ways in which he violated and abused his young daughter), she turned that stare on me. I squirmed inside—because though I had known her for more than a year at this point, her gaze still felt razor sharp.
But now, I asked her, “Sam, your stare is so intense. What are you thinking?”
“I’m just so confused. How could you hate my father?” Her gaze remained intent—demanding an answer.
I reviewed the hours we had spent talking about her deep-seated sense of worthlessness, her difficulty with trust and commitment in relationships, her hospitalizations and episodes of homelessness. And I linked them to the abuse she had experienced.
“He hurt me? Is that all you have heard? He read to me, he introduced me to Dylan Thomas and Charles Bukowski. Sylvia Plath—he read Sylvia Plath to me! He was so proud of me, Rachel. He gave me poetry. He believed in my writing. Don’t you know that I love him?”
The trauma that Sam experienced was devastating. It affected her brain development and ability to form healthy relationships. It set her on a trajectory of financial instability and homelessness, physical and mental health difficulties. No one should experience these difficulties, especially not at the hands of a parent. Her father was solely responsible for sexually violating and betraying her, for robbing her of the ability to grow up with a secure and trusting foundation. The price of love was violation, betrayal, and loss.
Sam had experienced intense betrayal—her father who she loved and depended on had violated her basic trust and sense of well-being by abusing her. Like any child who is abused, she made the best choices available to her to minimize her suffering. If she had withdrawn, it would have caused further emotional or physical harm. The best choice was to continue to maintain her relationship with her father—a choice that required she suppress and minimize the effects of the abuse—a pattern that continued into adulthood. This is what can be so confusing and hard to understand about responses to trauma. The response we expect when we hear about betrayal or abuse is complete withdrawal from the abusive situation. But then what is left? Children depend on their parents for love, protection, and sustenance. Without a primary relationship a child is completely lost, alone, and isolated. Sam needed to tolerate the abuse to maintain the relationship; that was the trade-off. Focusing on the positive aspects of the relationship with her father helped her cope as a child; it was a defense against the devastating pain of the betrayal—a survival strategy. But as an adult, it left her unable to access the deep-seated feelings of loss that are the centerpiece of interpersonal trauma. Accessing those feelings would require her to acknowledge the overwhelming pain of losing a person she deeply loved and depended on—and the grief and anguish would be overwhelming painful. Her feelings of hope and love were her way of keeping the pain of primary loss and betrayal at bay. My job was to help her work through these feelings—to be there for her and help her grieve.
In her visionary book, Trauma and Recovery, Judith Lewis Herman writes: "It is very tempting to take the side of the perpetrator. All the perpetrator asks is that the bystander do nothing. He appeals to the universal desire to see, hear and speak no evil. The victim, on the contrary, asks the bystander to share the burden of pain. The victim demands action, engagement and remembering.” My job was to take Sam’s side: to bear witness to the abuse that she had suffered, to the overwhelming grief and loss she had warded off through alcohol and drugs, cutting and suicidal thoughts. Through hope and love for her father. How much easier it would have been in the moment to engage with her hope, with her love, to continue to avoid the devastation of her childhood.
We need to spend more time practicing understanding and compassion, to not be afraid of intense pain, grief, and suffering. When we learn that as many as 1 in 3 girls in the United States experience sexual abuse before the age of 18 and that 75% of these cases are perpetrated by someone well known to the victim, we need to sit with the despair that evokes instead of rushing to find reasons why it is not our responsibility. We all have many reasons why we don’t need to do anything beyond noting these facts—but until we can allow ourselves to appreciate and feel the suffering and despair in our communities, until we can create space for more comprehensive and nuanced ways of understanding each other, we will continue to hurt each other.
Let’s move together toward healing.
*Not her real name. While all of the events described come from actual cases, this story is a composite to protect identities.
Image by Jeff Olivet
Need help?
RAINN (Rape, Abuse, and Incest National Network)
1.800.656.HOPE (4673)
Online hotline: https://ohl.rainn.org/online/
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