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[…]how someone supposedly “makes” a clinician feel can confirm diagnoses like BPD [“borderline personality disorder”]. When I have feelings about my clinician, those feelings are attributed to me and my past. When my clinicians have feelings about me, they are ALSO attributed to me and my past. Somehow, the clinician ceases to exist as an individual who has their own experiences and emotional reactions, and the patient becomes some kind of all-encompassing emotion monster, whose feelings are so enormous, they fill up the entire space, including the clinician.

Wren Aves, “‘My Doctor is Lacking Insight’: Alternative Experiences of Insight in Mental Health”, Psychiatry Is Driving Me Mad (blog), May 7, 2022

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[text of book cover: “BLACK / DISABILITY / POLITICS / SAMI SCHALK”]

Sami Schalk, Black Disability Politics (Durham, North Carolina, United States: Duke University Press, October 2022), https://doi.org/10.1215/9781478027003

this is an open-access version of Black Disability Politics, per Schalk’s wishes!

h/t Lucy Costa

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Skip Google for Research

As Google has worked to overtake the internet, its search algorithm has not just gotten worse.  It has been designed to prioritize advertisers and popular pages often times excluding pages and content that better matches your search terms 

As a writer in need of information for my stories, I find this unacceptable.  As a proponent of availability of information so the populace can actually educate itself, it is unforgivable.

Below is a concise list of useful research sites compiled by Edward Clark over on Facebook. I was familiar with some, but not all of these.

⁂

Google is so powerful that it “hides” other search systems from us. We just don’t know the existence of most of them. Meanwhile, there are still a huge number of excellent searchers in the world who specialize in books, science, other smart information. Keep a list of sites you never heard of.

www.refseek.com - Academic Resource Search. More than a billion sources: encyclopedia, monographies, magazines.

www.worldcat.org - a search for the contents of 20 thousand worldwide libraries. Find out where lies the nearest rare book you need.

https://link.springer.com - access to more than 10 million scientific documents: books, articles, research protocols.

www.bioline.org.br is a library of scientific bioscience journals published in developing countries.

http://repec.org - volunteers from 102 countries have collected almost 4 million publications on economics and related science.

www.science.gov is an American state search engine on 2200+ scientific sites. More than 200 million articles are indexed.

www.pdfdrive.com is the largest website for free download of books in PDF format. Claiming over 225 million names.

www.base-search.net is one of the most powerful researches on academic studies texts. More than 100 million scientific documents, 70% of them are free

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“If a person cannot solve a conflict with a friend, how can they possibly contribute to larger efforts for peace? If we refuse to speak to a friend because we project our anxieties onto an email they wrote, how are we going to welcome refugees, immigrants, and the homeless into our communities? The values required for social repair are the same values required for personal repair. And so this discussion must begin in the most micro experience. Confusing being mortal with being threatened can occur in any realm. The fact that something could go wrong does not mean that we are in danger. It means that we are alive. Mortality is the sign of life.”

— Sarah Schulman, Conflict is Not Abuse: Overstating Harm, Community Responsibility and the Duty of Repair

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“To begin by always thinking of love as an action rather than a feeling is one way in which anyone using the word in this manner automatically assumes accountability and responsibility. We are often taught we have no control over our "feelings." Yet most of us accept that we choose our actions, that intention and will inform what we do. We also accept that our actions have consequences. To think of actions shaping fee lings is one way we rid ourselves of conventionally accepted assumptions such as that parents love their children, or that one simply "falls" in love without exercising will or choice, that there are such things as "crimes of passion," i.e., he killed her because  he loved her so much. If we were constantly remembering that love is as love does, we would not use the word in a manner that devalues and degrades its meaning. When we are loving we openly and honestly express care, affection, responsibility, respect, commitment, and trust.” 

hooks, b. (2010). All About Love: New Visions

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“Severe separations in early life leave emotional scars on the brain because they assault the essential human connection: The [parent-child] bond which teaches us that we are lovable. The [parent-child] bond which teaches us how to love. We cannot be whole human beings- indeed, we may find it hard to be human without the sustenance of this first attachment.”

Viorst, J., as cited in hooks, b. (2000). All About Love: New Visions. p15.

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“Learning faulty definitions of love when we are quite young makes it difficult to be loving as we grow older. We start out committed to the right path but go in the wrong direction. Most of us learn early on to think of love as a feeling. When we feel deeply drawn to someone, we cathect with them; that is, we invest feelings or emotion in them. That process of investment wherein a loved one becomes important to us is called "cathexis." In his book Peck rightly emphasizes that most of us "confuse cathecting with loving." We all know how often individuals feeling connected to someone through the process of cathecting insist that they love the other person even if they are hurting or neglecting them. Since their feeling is that of cathexis, they insist that what they feel is love. 

When we understand love as the will to nurture our own and another's spiritual growth, it becomes clear that we cannot claim to love if we are hurtful and abusive. Love and abuse cannot coexist. Abuse and neglect are, by definition, the opposites of nurturance and care. Often we hear of a man who beats his children and wife and then goes to the corner bar and passionately proclaims how much he loves them. If you talk to the wife on a good day, she may also insist he loves her, despite his violence. An overwhelming majority of us come from dysfunctional families in which we were taught we were not okay, where we were shamed, verbally and/or physically abused, and emotionally neglected even as were also taught to believe that we were loved. For most folks it is just too threatening to embrace a definition of love that would no longer enable us to see love as present in our families. Too many of us need to cling to a notion of love that either makes abuse acceptable or at least makes it seem that whatever happened was not that bad.” 

hooks, b. (2000). All About Love: New Visions. 

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“All the years of my life I thought I was searching for love I found, retrospectively, to be years where I was simply trying to recover what had been lost, to return to the first home, to get back the rapture of first love. I was not really ready to love or be loved in the present. I was still mourning-clinging to the broken heart of girlhood, to broken connections. When that mourning ceased I was able to love again.”

hooks, b. (2000). All About Love: New Visions. px.

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“Particularly in the United States, race has always played a central role in constructing presumptions of criminality. After the abolition of slavery, former slave states passed new legislation revising the Slave Codes in order to regulate the behavior of free blacks in ways similar to those that had existed during slavery. The new Black Codes proscribed a range of actions-such as vagrancy, absence from work, breach of job contracts, the possession of firearms, and insulting gestures or acts-that were criminalized only when the person charged was black. With the passage of the Thirteenth Amendment to the Constitution, slavery and involuntary servitude were putatively abolished. However, there was a significant exception. In the wording of the amendment, slavery and involuntary servitude were abolished "except as a punishment for crime, whereof the party shall have been duly convicted.” According to the Black Codes, there were crimes defined by state law for which only black people could be "duly convicted." Thus, former slaves, who had recently been extricated from a condition of hard labor for life, could be legally sentenced to penal servitude. 

In the immediate aftermath of slavery, the southern states hastened to develop a criminal justice system that could legally restrict the possibilities of freedom for newly released slaves. Black people became the prime targets of a developing convict lease system, referred to by many as a reincarnation of slavery. The Mississippi Black Codes, for example, declared vagrant “anyone/who was guilty of theft, had run away [from a job, apparently], was drunk, was wanton in conduct or speech, had neglected job or family, handled money carelessly, and [...] all other idle and disorderly persons. " Thus, vagrancy was coded as a black crime, one punishable by incarceration and forced labor, sometimes on the very plantations that previously had thrived on slave labor.” 

Davis, A. (2003). Are Prisons Obsolete? p28-29.

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The traumatic event challenges an ordinary person to become a theologian, a philosopher, and a jurist. The survivor is called upon to articulate the values and beliefs that she once held and that the trauma destroyed. She stands mute before the emptiness of evil, feeling the insufficiency of any known system of explanation. Survivors of atrocity of every age and every culture come to a point in their testimony where all questions are reduced to one, spoken more in bewilderment than in outrage: Why? The answer is beyond human understanding. 

Beyond this unfathomable question, the survivor confronts another, equally incomprehensible question: Why me? The arbitrary, random quality of her fate defies the basic human faith in a just or even predictable world order. In order to develop a full understanding of the trauma story, the survivor must examine the moral questions of guilt and responsibility and reconstruct a system of belief that makes sense of her undeserved suffering. Finally, the survivor cannot reconstruct a sense of meaning by the exercise of thought alone. The remedy for injustice also requires action. The survivor must decide what is to be done. 

As the survivor attempts to resolve these questions, she often comes into conflict with important people in her life. There is a rupture in her sense of belonging within a shared system of belief. Thus she faces a double task: not only must she rebuild her own “shattered assumptions” about meaning, order, and justice in the world but she must also find a way to resolve her differences with those whose beliefs she can no longer share. Not only must she restore her own sense of worth but she must also be prepared to sustain it in the face of the critical judgments of others.

Herman, J. (1992). Trauma and Recovery: From Domestic Abuse to Political Terror.

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Consciousness raising opens up the possibility of living, not merely theorising about, a collective perspective. It can give us the resources to behave, think and act differently at work (if it makes any sense to talk about being ‘at’ work any more), where capitalist realism has become second nature. The roots of any successful struggle will come from people sharing their feelings, especially their feelings of misery and desperation, and together attributing the sources of these feelings to impersonal structures, albeit impersonal structures mediated by particular figures to which we must attach populist loathing.

In the harsh conditions of cyberspatialised capitalism – conditions that, as Jennifer M Silva demonstrates, have produced a “hardening” of the self, especially in the young – consciousness raising can produce a new compassion, for others and for ourselves. Neurotic-Oedipalising capitalism responsibilises, harshly blaming us, while – in its therapeutic mode – telling us that we have the power as individuals to change anything and everything: if we’re unhappy, it’s up to us to fix it. Consciousness raising, meanwhile, is about positive depersonalisation: it’s not your fault, it’s capitalism. No individuals can change anything, not even themselves; but collective activation is already, immanently, overcoming individualised immiseration.

Mark Fisher, abandon hope (summer is coming)

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cw: incest, csa, rape, multiple perpetrators, detailed

“A content analysis of these fourteen interviews identified three distinct, yet interrelated, themes. First, both family members and others, including friends and authorities, were perceived as responding with denial/minimization/normalization of CSA. A second theme was noted when participants spoke about other methods family members used to ensure their cooperation and/or silence about polyincest. Characterized by implicit and explicit threats, this was labeled fear/reprisal. The third theme to emerge related to the reactions of friends and authorities outside the family. Common patterns of response were characterized as inadequate/negative. 

In 13 of 14 there are narrative examples of denial/minimization/normalization from both family members and others. These accounts revealed the ways in which participants thought the reality of their abuse was hidden or overlooked. Insofar as denial/minimization/normalization served to protect the abusers from exposure, while simultaneously leaving the child unprotected, both family members and others demonstrated collusion with sexual abuse. 

Fannie was raised in a white, nuclear family with strong connections to extended family members. Based on her account, there appeared to be a pattern of sexual abuse among male relatives (i.e., both grandfathers, father and brother). As an adult, her efforts to confront her father with his incest were met with simple denial, “This never happened.” Other family members seemed intent on colluding with the sexual abuse when they refused to react to disclosures of it. For instance, when Fannie sought support in the face of her father’s denial, an aunt who had earlier disclosed to Fannie that she had been a victim of sibling incest by her older brother (Fannie’s father), didn’t want to discuss it further. According to Fannie, her aunt “wished she had never disclosed that … she would take that validation away if she could to protect herself.” In another account of how her family knew about the history and potential for incest, yet failed to act, Fannie talked about efforts by an aunt and uncle to disclose the sexual abuse of their own children by the same grandfather. 

They made a trip to my house for the express purpose of sitting my parents down and… they did actually say it. And my father said he would handle it. And a couple of weeks went by and my aunt got the message back … and it was clear that nothing was going to be done or prevented. 

Linda was a young, white woman who had been raised by a single mother for most of her childhood. She reported being exposed to multiple abusers because of her mother’s active social life which included numerous boyfriends, parties, and heavy alcohol use. She identified her abusers as her mother, a male cousin, and two male family friends. Normalization of sexual abuse was evident in her statement, “I can remember … umm … them being drunk and touching and fondling and how uncomfortable I felt.” When Linda was eight, she tried to tell her mother that she had been raped by a teenaged cousin. Denial and reprisal were both evident in her account of her mother’s response, “I told her when it happened and she slapped me across the face. Told me I was lying. It never happened, yeah.” Years later, as an adult, Linda reminded her mother of this incident. Minimization was evident in her account of her mother’s reply, “ ‘Oh, that. I knew about that years ago. You had a wonderful childhood. We don’t need to talk about those …’ She said it was no big deal too, I guess.” 

Letitia, a young African American woman, had been raised in urban poverty by a drug addicted mother and stepfather. She reported abuse by 3 family members, including her mother, stepfather, and stepgrandfather, as well as several other, nonfamily members. Her childhood and early adolescence were spent in a large step-family. She also had contact with her maternal grandmother, aunts, uncles, and cousins in an extended kinship network. In another example of collusion with sexual abuse, she noted: 

Later on, I found out a lot of my family did know about what was happening when we were little, but they didn’t want to interfere. Like it was just not done, you don’t talk about it, you don’t interfere. 

Growing up in a white, rural, working-class area, Celia and her siblings were frequently shunted back and forth between extended and stepfamilies. She was multiply sexually abused by her father, stepfather, uncles, and others throughout childhood. Incest and violence were norms for her. When explaining how she knew that her sisters also had been sexually abused, Celia stated, 

Because you could hear him go from room to room. You know, you could hear him, like you know that you are going to be next. And you know. I think that was the worst, knowing that he was coming. 

As adults, even former victims were prepared to collude with the intrafamilial, intergenerational pattern of incest. Based on one sister’s comments, urging her to ignore the past, minimization and normalization of polyincest appeared to continue in Celia’s family, 

And my sister defends him … his father was like this and his father’s father before that and … it was like ‘big deal.’ And he knew he could get away with it. More or less, he did. 

Outside of their dysfunctional families, participants also reported numerous examples of denial/minimization/normalization. In fact, reactions by both significant others and authorities seemed to mirror the same collusive responses found within polyincestuous families. Linda commented, 

Some of my friends that I have told, because it was so extensive, they don’t want to believe it either. They would close their eyes and think that it doesn’t happen in this world. 

Donna and Kate, white women from extended and nuclear families respectively, discussed reactions within their Christian communities of faith. In similar ways both encountered resistance to the disclosure or discussion of incest. Donna, who reported a network of related and unrelated perpetrators, noted, “They accepted … in the beginning. And then it’s like, ‘ok, that’s it. Go on.’” Kate felt even less acceptance, “They are not open to it.” She struggled with tears while saying, 

As much as I have wanted to trust people, … it has hurt me because the people that you really want, that are supposed to be close to God, can’t quite say ‘I don’t understand what you are going through, but I back you up.’ 

Jane, a white woman raised in a chaotic, nuclear family, reported long term sexual abuse by a violent, alcoholic father, as well as a male cousin and unrelated men. She was convinced that people inside and outside her family knew or suspected sexual abuse, but did nothing, “because my family was so loud and messy about their abusiveness and … and it was just so loud and messy and there were so many people that knew it.” 

Reflecting a similar view, Letitia believed that people, inside and outside the family, often did know or at least suspected when she was being sexually abused, “I don’t know. I think stuff like that (e.g., incest and rape) happens a lot more and people just don’t say anything about it because they are embarrassed.” Later in the interview, she connected people’s reluctance to take action with what she considered a kind of normative sexism in the larger society. Giving examples from music lyrics, a comedian’s joke about “a fat woman wearing a rape whistle,” and sex/rape simulations in music videos, she remarked, 

The media and everything I see really affects me a lot because it just makes me see the mind set of society at large. I’m just inundated with things that make me think, ‘God, now I can understand why my parents are this way.’ 

Although denial/normalization/minimization seemed aimed at discouraging victim/survivors from bringing attention to their plights, it was sometimes not enough. Eleven of the 14 interviews contained examples of fear/reprisal, in the form of threats, blame, and/or shaming. Celia’s experience may have been the most severe. 

Celia: He [father] told us horror stories. He was good at twisting things and brainwashing, very good. 

Interviewer: How did he do that? Can you say more about that? 

Celia: He would um … put it in the sense like, ‘If you don’t love me and you don’t show me that you love me, God isn’t going to accept you.’ 

Later she remarked, “My stepfather did that too. If you told, bad things were going to happen to you, you know.” 

Eudora was raised in a rural, white, nuclear family that was strictly religious. In addition to incest by two brothers and an uncle, she described alcoholism and physical abuse by both parents. When she was in her early teens, Eudora experienced a different form of silencing through reprisal when a youth leader in her church was discovered molesting her, “… then I got locked in my room for three days because it was also my fault.” 

Finally, Letitia explained that fear of the consequences of disclosure seemed to be a major factor in her grandmother’s silence about her sexual abuse in childhood. 

… like my grandmother was really afraid that… that we … she said that she was afraid that my mother would take us away and we would never see her. But I don’t know. It doesn’t make sense to me. 

When directly confronted with the disclosure of incest and/or sexual abuse, various confidants and authority figures were seen as inadequate/negative in their responses by 9 of the 14 polyincest survivors. For instance, at the age of thirteen Letitia had been raped by her stepfather. He received a four year prison sentence, while she was placed in foster care throughout her adolescence. During that time, she was assigned to a caseworker whom she grew to despise, “A lot of times she would say, you know, ‘are you sure some of the things that happened to you weren’t just them being affectionate?’” 

At another point in her adolescence Letitia was raped by the star football player at her high school. She only revealed the rape to a trusted foster-brother because she saw little reason to report it as a crime. Perseverating on the idea that many different people in authority were aware of this young man’s actions, she claimed, 

And it was just … like everybody knew about it. But…I don’t know. Everybody knew. And the teachers knew, I mean everybody knew. It was a totally different set of reasons for not doing anything about it [comparing family’s nonresponse with authorities’ nonresponse], you know. And he was really a big man on campus. Sports and just kind of like prestige are such a big thing in high school and college. 

Later she added, “And he did it to other girls, too.” 

Celia’s account was equally disturbing. Like Letitia, she had been raped by her stepfather in early adolescence after years of other sexual and physical abuse. She got into trouble at school for violent behavior and, when questioned about the reasons for her behavior, revealed the rape. 

Celia: He admitted to doing everything. And so, because he was a working man, he got a 90 day jail sentence, which he only had to attend on weekends, and a year’s probation. You know, … 

Interviewer: When did you take him to court? 

Celia: When they put me in foster care. I had no choice actually. You know, they make you feel like shit. They treated him better than they treated me. 

As each of them entered puberty, Kate and her two sisters were sexually abused by their father. Subsequently, she was also raped by her stepfather, sister, and a male neighbor. In her mid-twenties she had what was described as a “nervous breakdown” and entered a psychiatric hospital for treatment of a variety of symptoms related to her history of incest. While hospitalized, she was assigned a doctor who interpreted her incest this way. 

And he … he said he wanted … he tried to get me to talk about it. And when he told me um … He said, ‘well you must have loved your father very much.’ And I … he didn’t say why he said that. I just absolutely wanted to run out of there. 

Like other survivors of polyincest, Kate had little confidence that friends or authorities would be helpful to her ongoing recovery from a long history of incest and rape. She relied instead on the emotional support of a local self-help group for sex abuse survivors. 

These 14 narratives represented perhaps the most severe forms of incest that a child can suffer and survive. Yet, the themes that emerged from them revealed a consistent lack of any adequate response by other adults, thus insuring that their sexual abuse would be effectively ignored. Within both nuclear and extended families, relatives failed to respond to either their suspicions or to outright disclosure of polyincest in ways that would confront the perpetrator or protect the victim from further assaults. Outside the family, caseworkers, physicians, judges, church members, and friends often failed to adequately support the victim in childhood or the survivor in adulthood.”

M. Sue Crowley & Brenda L. Seery, Exploring the Multiplicity of Childhood Sexual Abuse with a Focus on Polyincestuous Contexts of Abuse 

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Fascist violence was neither random nor indiscriminate. It carried a well-calculated set of coded messages: that communist violence was rising, that the democratic state was responding to it ineptly, and that only the fascists were tough enough to save the nation from antinational terrorists. An essential step in the fascist march to acceptance and power was to persuade law-and-order conservatives and members of the middle class to tolerate fascist violence as a harsh necessity in the face of Left provocation. It helped, of course, that many ordinary citizens never feared fascist violence against themselves, because they were reassured that it was reserved for national enemies and “terrorists" who deserved it.

— Robert O. Paxton, The Anatomy of Fascism (2004), Ch. 3.

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“Not being respected as a human being 

Most of the text was included in this core theme, containing the participants’ descriptions of negative experiences and comprising by the three themes: ‘not being involved in one’s own care’; ‘receiving care perceived as meaningless and not good’; and ‘being an inferior kind of human being’. 

Not being involved in one’s own care 

The participants talked about not being listened to and not being heard. One participant said: ‘You haven’t been heard, the staff only pass you by.’ They described not getting answers when asking questions and not receiving a response when trying to initiate dialogue with the staff. Participants reported that when trying to express their wishes, for example, to be discharged, the result was an extended hospital stay, and thus the best thing was to remain silent, to agree and not to protest. As one participant put it: 

‘Simply because I said I wanted to be discharged they extended my involuntary status … if you don’t behave you will not have permission … you have to be good and docile.’ 

The participants described lack of information about their treatment and their rights as involuntary patients. They spoke of having inadequate information or knowledge and difficulty understanding the reasons for involuntary care. One participant said: 

‘I still don’t know who made the application for my involuntary hospitalization and for what reasons. I have asked but nobody will answer and the psychiatrist in charge never shows up at the ward.’ 

For these participants, it was difficult to understand the staff’s roles, actions and decision-making as well as the ward’s rules and their functions. The participants reported that when staff were asked the reasons for the use of coercive measures, for instance forced medication, they replied only that the participant was in involuntary care, or they did not give any reason at all. 

Receiving care perceived as meaningless and not good 

Participants described difficulty in understanding why they should receive involuntary hospitalization, as they perceived the care only as a form of storage, with nothing happening, and no opportunity to talk or receive psychotherapy. One participant said: 

‘I think there is no point in being locked in as nothing is happening here, this isn’t any direct care. It is on the whole only storing away. If I am locked in something should be happening, so there is an opportunity to talk to somebody almost all the time or at least every day.’ 

Many said that their problems were not taken seriously, that they were only treated with medication, and that they were frightened. Complicated by the feeling of fear was the presence of frightening copatients and medications that altered one’s thinking and feelings, along with uncomfortable side-effect including drowsiness and mental dullness, making it even more difficult to work on one’s problems. One participant said: 

‘I have had medication several times but it never helped me, it made me more confused. I couldn’t recognize myself as I became a robot. All the time they want to fix the symptoms, they really don’t get to the bottom of the problems causing the trouble.’ 

Nursing staff were described as lacking competence and not knowing what to do. The participants described their contact persons as not having time, being distant, only ‘running around’, not working during the whole of the participant’s hospitalization period, or having one contact person instead of two. Some of the participants had the impression that the staff enjoyed using coercion against them. Participants reported not having met a single doctor during their entire hospitalization period, although they had asked to see a doctor. Physicians were described as prisoners of their professions who lacked time, were distanced from the patients, and saw only a sick patient and not the human being. As one participant said: 

‘The worst thing you can hear from the person who decides over your life and treatment is that he/she does not have time for you.’ 

Being an inferior kind of human being 

Participants described involuntary admission as a state of feeling and being inferior as human beings. ‘You become a nobody, they can do whatever they want with you, although maybe you are a very valuable person being in a crisis.’ They spoke of being violated and depreciated by staff as well as by police. They told about not being spoken to, nor involved in planning, not being informed before the police arrived and not having the opportunity to open their own door themselves. As indicated by one participant: 

‘Before I managed to put on my clothes, our caretaker unlocked the door to two policemen, just entering like that, I think it is rather … I would have unlocked the door myself if I had only had my clothes on.’ 

Participants described feeling not capable or worthy and being changed into another kind of person, for example by medication. They spoke of not being allowed to have and express feelings and variations in mood/temper as other people normally do[.] […] 

Participants described involuntary admission and forced injection as a punishment. […] 

Participants also described feeling inferior as a person and in society, not respected as a psychiatric patient, being a ‘bad person’, a person with less knowledge. They expressed that, as a psychiatric patient, you have to maintain your own value and try to be as good as others.”

B. Olofsson and L. Jacobsson, A plea for respect: involuntarily hospitalized psychiatric patients’ narratives about being subjected to coercion 

[criticalinvert]

Although attention to trauma increased dramatically in the mental health community after the arrival of the post-traumatic stress disorder (PTSD) diagnosis, researchers have, until recently, focused predominantly on the relationship of trauma to non-psychotic disorders. Meanwhile, the possibility of a relationship with psychosis has been minimized, denied or ignored. The possible reasons for this selective attention have been discussed elsewhere (1), and include rigid adherence to a rather simplistic biological paradigm, inappropriate fear of being accused of familyblaming, avoidance of vicarious traumatization on the part of clinicians and researchers, and rediagnosing from psychosis to PTSD, dissociative disorders and other non-psychotic diagnoses once abuse is discovered. 

There is now substantial evidence linking child sexual abuse (CSA) and child physical abuse (CPA) to a range of mental health problems in childhood (2). Child abuse has also been shown to have a causal role in most adult disorders, including: depression, anxiety disorders, PTSD, eating disorders, substance abuse, sexual dysfunction, personality disorders and dissociative disorders, as well as suicidality (3–10). Some of these problems are common in people diagnosed as schizophrenic. 

Moreover, child abuse is related to severity of disturbance whichever way one defines severity. Patients subjected to CSA or CPA have earlier first admissions, longer and more frequent hospitalizations, spend longer in seclusion, receive more medication, are more likely to self-mutilate and to try to kill themselves, and have higher global symptom severity (3, 10–19). In one study, suicidality in adult out-patients was better predicted by childhood abuse than by a current diagnosis of depression (17). Studies of bipolar disorder have found child abuse and neglect to be related to earlier onset, severity of mania, number of manic episodes, clinical course and, again, higher rates of suicide attempts (13, 20, 21).

Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications

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Emergent types of disclosure 

Behavioral. This category emerged from narratives of participants depicting the intentional use of non-verbal behavior as children and adolescents to convey a message that something was amiss. […] Participants described behaviors connected to the abuse and their wish to have an adult detect that there was something wrong. 

“I remember grade ten through twelve, I would be terrified to go home. I would stay until the doors closed at school and the teachers always wondered why are you staying here so late, why don’t you go home? I don’t want to go home.” 

The following example was provided by a participant who hoped her angry outbursts, as a teenager, would be interpreted as something more:

“It was hard, you know, cause there would be days I’d come home all angry and she [mother] would be ‘what’s wrong?’ ‘Like nothing, I’d say.’ ‘Nothing is wrong, don’t worry about it.’ Yeah, I think at one point I didn’t feel resentment to her, but I was like ‘Why aren’t you picking up on you know, maybe I am dropping small hints, my moods’?” 

She described these conscious gestures, through her moods, as hints given out about sexual victimization. As well as non-verbal behavior, in some cases, indirect verbal hints were made in attempting disclosure. These attempts were beyond mere behaviors, yet were not detected as disclosure attempts. 

“… there were times when we tried to tell my mother or I did, like, leave her little hints …. Um, I would say something like, oh ‘can you come early tonight’ or ‘do you have to go to work?’ Um, I couldn’t come out and say it.” 

Ramona Alaggia, Many ways of telling: expanding conceptualizations of child sexual abuse disclosure  

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It is understandable for both patient and therapist to wish for a magic transformation, a purging of the evil of the trauma. Psychotherapy, however, does not get rid of the trauma. The goal of recounting the trauma story is integration, not exorcism. In the process of reconstruction, the trauma story does undergo a transformation, but only in the sense of becoming more present and more real. The fundamental premise of the psychotherapeutic work is a belief in the restorative power of truth-telling.

Herman, J. (1992). Trauma and Recovery: From Domestic Abuse to Political Terror.