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Ruth Cohn
   
The Essential Female Tragedy – Changing the Ending:
Therapy with Mothers and Daughters of the Incest Family

“The loss of the daughter to the mother, the mother to the daughter, is the essential female tragedy.”
- Adrienne Rich

On a dark November afternoon, I received an unusual phone message from a woman in Southern California. She had gotten my name from her daughter, and she wanted to come and see me. When I called her back, I heard an anxious, strained voice, “Thanksgiving brought it all up again, as the holidays do every year. There is a rupture in our family that tears me apart.”

She introduced herself as Betty and proceeded to tell me a bit of the story. Her daughter, after uncovering her sexual abuse, had broken off contact with Betty and her husband. This woman had not seen her daughter in four years; they had not spoken in almost two. She desperately missed her daughter, Sarah. Sarah, who had been in couple’s therapy with me some time ago, had asked her to call me to see about the possibility of their doing some work together.

I was intrigued. This woman was proposing to fly up weekly or biweekly, pay for the sessions, and work to heal their divided family. “She’s my daughter,” she almost wailed. Thus began my journey of mother-daughter work with women from families coping with incest.

As long as I have been working with survivors of childhood sexual abuse, I have observed that grief about the mother is among the deepest wounds to be healed. Along with rage at the mother, this grief tends to be far greater than any feelings about the perpetrator of the abuse. I have also seen the most extreme denial, and an urgency about trying to preserve an image of the ideal mother, including survivors saying barely tongue in cheek “My mother was perfect.” When they begin to see her more clearly, they feel truly orphaned. How could she not have noticed? Why didn’t she stand up for me? How could she have stayed with him? These questions haunt and torture them.

The first session was with Betty alone, and it seemed to be an act of maternal heroism. This was the first time she had flown in an airplane by herself, and she navigated from the airport to an address in a strange city. She was a 50’s mom with the look of a farm girl. Active in her church and involved with her social service job, she was kindly and well meaning. She and her husband had been in therapy briefly when Sarah had originally raised the issue of the abuse, working with a therapist who had a decidedly “false memory syndrome” perspective. Betty was otherwise not particularly psychologically minded. She needed to check me out. She knew that I specifically work with survivors of trauma and she was not sure if I would view her as a villain.

The objective of the first session for me, besides building rapport, is to explore the motivation for the work and the nature of the hoped-for outcome. Some mothers are looking to make the problem go away. I need to let them know that this therapy will not be an argument about “what really happened”. It will not be a process for one or the other to make a case for what is the truth, and attempt to prove it. If that is the desired outcome, then we know right there to go no further. So far that has not happened. Betty said she was willing to “do anything to bring Sarah home.”

I described to her how I work. I use the same approach I use for working with couples, which involves a structured format called “Intentional Dialog” adapted from Harville Hendrix’s Imago Relationship Therapy. We also discussed logistics, how we might set things up to take into account the time and expense of her travel. We agreed to meet for weekly ninety minute sessions to start.

Betty and I seemed to make a connection, although I quickly realized that my neurological answers to her questions about traumatic memory were not what she really needed. Clearly, the process would be one of learning how to forgive one another and cope with having different memories and beliefs about the family’s truth.

The Character of the Mothers

What sort of women marry and stay with men who molest their daughters? Some themes have emerged over time through my work with these women. They tend to be children of neglect, often the unchosen among siblings. Betty was the “Ugly Duckling” among superstar sisters, although she never seemed to arrive at swan-dom. She suffered through her life within a brittle sense of worthlessness. Easily dominated, she was well prepared for a relationship of swallowing what she was dealt.

Often the women have their own experience of childhood trauma or witnessing trauma. Accustomed to neglect and minimizing of their own devastating experiences, they may resent or simply fail to understand why their daughter is “making such a big deal about the molest.” Spoken or unspoken, they may harbor a judgment of “I put mine behind me, why can’t you just get over it?” Yet for some reason they are here.

As is common with neglect, there may be a tendency toward some degree of dissociation. This may account for their capacity to not consciously know when the abuse was occurring. The mothers I have worked with have been strangers to their own feelings. Unaware of their other-directedness, they have to be taught how to talk about themselves, or how to even notice when they are not, let alone learning to become aware of their own emotions. They grew up in families where feelings were not discussed, so there was hardly a category for even feeling them. Betty was distressed and ashamed by her frequent tears in our sessions. To her it was a “breaking down” or “losing it,” that she would then apologize for.

For the mothers I have seen, being a mother had been their life, and having been a good mother a vital midlife concern. Their great fear is that they were not good mothers. It has been the norm to vacillate between extremes of guilt and defensiveness. Finally, what I have seen is that something about their childhoods has prepared them for the role of being caught in the middle, a role which they have played for years in the incest family.


Mother Daughter Therapy

In general, I have seen four core clusters of issues to be worked through in the mother-daughter therapy. From the daughter’s point of view they would be: You knew; You chose him; Do I really want to know who you are and understand how this could have happened; and the question of forgiveness. The first two, intimately entwined together, are the deepest wounds that survivor daughters tend to bring. They are incomprehensible and heartbreaking to imagine. Sarah lamented, “even if my kitten is under the weather I notice something is wrong. I was depressed, I cut myself, I was isolated and sad all the time, I didn’t eat and got emaciated. Even if you did not see the abuse, which is also unimaginable to me, how could you not have noticed that something was wrong?” It adds up to the most profound sense of annihilation and insignificance: “I did not exist for you. Invisible, I did not matter at all.”

Of course, if the mother did know then she clearly chose, whether actively or by default, to side with the father. If the daughter was significant enough or visible enough to be noticed, then the failure to protect, or the choice to turn a blind eye and maintain status quo, was intentional. Either is a profound rejection and unspeakable injury. Arriving at the point of being able to speak of such things is monumental. This is what the daughter has waited years to be able to say.

Finding words to describe these feelings, many of which have resided and ached within the survivor for decades, is Sisyphean at best. She both fears destroying the mother with them, or being ignored again. Either is tantamount to dying. The preparation is painstaking.

For Sarah and Betty, our work took some time. Our first session in which the two laid eyes upon one another for the first time in four years was a moment of awe. The complex mix of anger, hurt, longing, fear, love and desperate relief were a bittersweet variation on the Prodigal Son. It was the Prodigal Daughter, or the Prodigal Mother, and one of those privileged moments in psychotherapy that feel really too intimate as to include the therapist. It took my breath away. Sarah had dressed up, and looked more beautiful than I had ever seen her. Betty was a warrior woman having marched triumphantly in from the airport shuttle. The first session or two was a tentative, frightening and thrilling reunion, filled with looking at each other and catching up on news of their and their families’ lives.

From there it was a natural progression and important ground work for Betty to share stories with Sarah about her own childhood. As is generally true with neglected children, Betty did not even really know she had a story to tell. She certainly had no experience of the power and connection of sharing that story, especially with her daughter. She also told Sarah about the early years of her marriage with Sarah’s father, the financial pressure, the shame around the idea of a second divorce, the demand of Sarah’s disabled little sister on her time and reserves of patience and energy. Mother and daughter were creating a new connection which allowed them to get to know each other in ways they never had. For the purposes of the therapy, we were creating a context that might help Sarah ultimately make sense out of her mother’s failing her. It also created more balance in the therapy, depathologizing Sarah. If Betty’s story was also important to the work, Sarah felt less the “problem child” when she described her own. We were also creating a safe container, in the relationship with me and in the structure of the therapy.

Once under way, the work became difficult immediately. Betty had a strange suspicion of some sort of secrecy. Somehow she had unconsciously transformed the question “you knew” into a fear that Sarah suspected she was hiding something. She rather franticly tried to dispel this, but it was hard for Sarah to understand.

Sarah wanted for Betty to understand her feelings and how the trauma had affected her whole life. But somehow this sounded to Betty like a return to the argument about what really happened, and the court-like questions of blame and guilt. At this stage it seemed untenable to work less than once a week. There was not enough object constancy in the context of so much fear. The intense feelings, particularly Sarah’s emerging anger, would have been too much to hold for more than a week at a time, and there would not have been enough momentum to sustain hope for change.

There was another difficulty particular to this work. Betty went home each week to her husband, this same husband who had molested Sarah. For her it was like moving between one reality and another, one world and another. She struggled to keep her footing in both. Even though she was not discussing the therapy with her husband, she was returning to the world of denial, the world of his defensive, if unspoken, rage. It confused and ungrounded her.

With her inexperience with therapy and foreignness to feelings, Betty interpreted her frequent tears and Sarah’s and her anger as “the therapy not working.” As her hope waned, she began to complain about the trips and the expense. So, with some hesitation on my part, we began to meet once or twice a month for three or four hour sessions. Often my schedule did not allow full three or four hour blocks, so there might be a break of an hour or 90 minutes that gave Sarah and Betty a bit of a push to go out and do something together, have a meal or go shopping in my Rockridge neighborhood. When they began to return to the office with clothes and things that Betty had bought for Sarah, or doggy bags from enjoyable lunches, I began to see what an inadvertent and vitally important component these breaks were: they were structuring and dosing normal time together into the therapy session.

As time went on, both of their deepest objectives seemed organically, gradually to be met. What both really wanted most of all was to be seen. For Sarah, it had been, “Mom, I want you to understand me, and how my life has been.” For Betty it had been, “Sweetheart I want you to understand that I am not a bad person or a bad mom. I want you to see who I am and that I have really loved you.” This was happening quietly through the dogged exercise of the dialog, which by definition lands each momentarily in the other’s shoes. The incest was ceasing to be the focus of the connection and disruption of connection of these two women.

A Word About the Dialog

The role of Intentional Dialog in this work must not be underestimated. Daniel Siegel and Alan Schore, big names in current attachment research, are understanding more and more about the neuroscience of early attachment experience, and how the interaction between mother and infant affects the biology of the child’s developing brain. It is unclear what the possibilities are about healing early neurobiological attachment deficits later in life. Siegel and Schore are hopeful that it is possible.

Siegel cites research that identifies the primary cross-cultural element of healthy attachment and subsequent mental health as the good- enough mothering sequence referred to as “Contingent Communication.” In this sequence, there are four elements: when the infant emits a signal, the mother perceives it accurately, makes sense out of it, arrives with the appropriate response, and does so promptly. Contingent communication soothes and teaches self-soothing to the infant, and facilitates development in the structure of the brain where affect regulation occurs. It is simple attunement, and yet painfully rare among our traumatized and neglected clients.

The structure of Intentional Dialog, which involves mirroring, summarizing, making empathic sense out of, and responding in the same predictable format, essentially replicates the process of contingent communication. Perhaps, in effect, Sarah and Betty were repairing the dysregulated attachment sequence of both of their early lives. I like to think that is part of what makes this work so powerful.

Changing the Ending

As time went on, Sarah and Betty were e-mailing and phoning each other between sessions. Betty began to plan longer trips around our sessions, where she might spend a weekend with Sarah and her husband. They began planning a trip across the country for a relative’s wedding. It was becoming clear that they needed me less and less.

Interestingly, it is not unusual for the perpetrator to become curious around this time. Perhaps they want to “find out who this Ruth is,” or explore their own possibilities in the family healing. Sometimes I have met with them, and the process has continued. But that would be another story.

A last hurdle for Sarah, as for many survivors, was about letting go of the trauma. What does it mean to see how this could have happened? What would it mean to accept her mother as she is, her love with her failings, Betty’s own childhood injury with her massive betrayal as a mother? Would seeing her as who she is mean the abuse was OK? Does it excuse her from her part in Sarah’s lifetime of Post Traumatic pain and life disruption? Does it mean defeat? These are all questions that a survivor must contend with in this work. Is forgiveness a kind of denial, giving in, or might it be a loving, spiritual high ground? For each survivor and each mother-daughter pair, this question and its answers may be different.

For Betty, a final hurdle was about reintegrating Sarah into the family without a disavowal or a recanting of the “heinous accusation.” Would that mean that Sarah “won”? Would that mean that all the pain, rage and shame of the rest of the family would fade away like a war without a monument? What would it mean to allow the family to change? Would that once again be “Sarah controlling the whole family”? These are questions the incest mother must wrestle with, especially if she continues to share a life with the perpetrator. They are no small thing. I view this as profound spiritual work. There is no right answer. Sarah and Betty, and others I’ve seen, have been moved by love (and of course they are the select few that find their way into a process like this) to end a legacy of tragic unconsciousness and heartbreak.

© 2002