Trauma and Countertrauma, Resilience and Counterresilience

Insights from Psychoanalysts and Trauma Experts

Richard B. Gartner, Richard B. Gartner

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317506317
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

Treating traumatized patients takes its toll on the treating clinician, giving rise over time to what Richard B. Gartner terms countertrauma in the psychoanalyst or therapist. Paradoxically, a clinician may also be imbued with a sense of optimism, or counterresilience, after learning how often the human spirit can triumph over heartbreakingly tragic experiences.

Trauma and Countertrauma, Resilience and Counterresilience brings together a distinguished group of seasoned clinicians, both trauma specialists and psychoanalysts. Their personal reflections show what clinicians all too rarely dare to reveal: their personal traumatic material. They then discuss how they develop models for acknowledging, articulating, and synthesizing the countertrauma that arises from long-term exposure to patients' often-harrowing trauma. Writing openly, using viscerally affecting language, the contributors to this exceptional collection share subjective and sometimes intimate material, shedding light on the inner lives of people who work to heal the wounds of psychic trauma.

By the same token, many of these clinicians describe how working intimately with traumatized individuals can affect the listener positively, recounting how patients' resilience evokes counterresilience in the therapist, allowing the clinician to benefit from ongoing contact with patients who deal bravely with horrific adversity. Paradoxically, a clinician may be imbued with a sense of optimism after learning how often the human spirit can triumph over heartbreakingly tragic experiences.

Trauma and Countertrauma, Resilience and Counterresilience will appeal to psychoanalysts, psychoanalytic psychotherapists, and trauma experts, offering a valuable resource to those beginning their careers in mental health work, to teachers and supervisors of trauma therapists, to experienced clinicians struggling with burnout, and to anyone who wants to understand the psychotherapeutic process or indeed the human condition.

Chapter 1
Trauma and Countertrauma, Resilience and Counterresilience^1,2

Richard B. Gartner

At the end of the 1952 film noir movie On Dangerous Ground, a character turns to the jaded, cynical detective played by Robert Ryan and says, "I guess you have to be tough in your line of work, don't you?'' Hearing this line and seeing the hard-bitten reaction on Ryan's face, I began to think about my own line of work, treating men with histories of sexual trauma, the toughness required in it, the cynicism it causes in me, and the reasons why I have nevertheless pursued this area so passionately over time and how I have been transformed by listening.

I begin with a vignette:

Seated as far away from me as he could, Duncan shifted in his chair and quickly glanced at me before averting his gaze to the ground. A man in his seventh decade—a husband, father, and grandfather—he coiled into himself as he whispered, "They did things..." His voice trailed off. "What kind of things?" I asked. "You know, bad things..." A long silence. "Go on." He looked at me, miserable. "I can't explain it... The girls, my friend's older sister and her friends, it wasn't really so bad." I looked at him and waited. "They took photos and said things to us." "Photos?" "We were..." and he paused, trying to find words, "We were naked, me and my friend," "Yes?...." He looked away. "We were having sex. They called us faggots and pussies. Day after day they gave us drugs and took photos." He paused and finally murmured, "I found the pictures on the Internet, dozens of them. I was nine, so small..."

I imagined what it would be like to find a photo of myself as a child on a kiddy porn site.³ I invite the reader to do the same.

My heart sank.

The first colleague to read the manuscript of my book Betrayed as Boys (1999) taught me how words about sexual abuse can traumatize the listener or reader. Of all her helpful comments, the only one I now remember is her scrawl after a series of case studies, "Richard, you are killing me!" I learned then how even written material, thirdhand descriptions of boyhood sexual trauma, could sicken the listener, even someone as seasoned as this colleague.

When I first began writing about male sexual victimization in the early 1990s, I was determined not to use euphemisms. Descriptions in the literature were often along the lines of "She was raped by her stepfather," or, worse, "His babysitter sexually abused him," or, worse still, "There was inappropriate touching/' These descriptors were shocking, yet uninformative. Often the reader had no idea what actually occurred. In addition, reports like this were somehow distancing, like a news report, and dry, like medical notes. (A notable exception is Davies and Frawley, 1994.)

But I was working with a population that at that time many, including professionals, did not believe even existed. It was important to convey the urgency of this population's needs while describing those needs with dignity. In my writing, I needed to be convincing but not pornographic, shocking when necessary, but not overblown. I wanted the skeptical reader to believe that boyhood sexual abuse exists. But I did not want that reader to think I was writing for the sake of titillation or to feel so repelled by my descriptions as to dismiss my work entirely. So I put substantial text between my case histories, trying to give readers some breathing space before the next onslaught of graphic detail. That is what I am doing right now.

Returning to Duncan, a few sessions later he told me about the boyfriends of the girls who filmed him. They were much older, tough young men who, partying with the girls, stripped him and his friend on many occasions. They dragged them and got them drunk, then tied them up, laughing and inserting large objects into them.

These scenes were appalling, of course, but in some ways they did not seem all that different from some of the worst cases I had treated over the years. In Betrayed as Boys, for example, I wrote about the heart-stopping moment a man described when his adoptive father inserted a presumably loaded revolver into his anus, later making him suck on it while the adoptive father raped him. About working with that patient I wrote,

I...needed to consider how I was listening and behaving. When did I find myself backing off and disbelieving [him]? When did I listen without asking the questions that would encourage him to talk more? When did I overidentify with him or think of him as a victim rather than a person? When did I overidealize him for his capacity to overcome extreme adversity?... When did I tune out, or want to?".

(Gartner, 1999, p. 265)

As for Duncan, it turned out he was merely testing me by telling me about the photos, the teenage girls, their adult boyfriends, and the indignities they forced on him. Over the course of many months, he decided I listened, believed, and did not judge him, and he noticed I asked him questions that helped him articulate his experience. Only then did he start to recount the long "relationship" he had throughout his teens with a coach. His upper middle-class parents were self-involved and neglectful—for example, they left their only child alone for several weeks a few times each winter to go on cruises and other vacations from the time he was 12. So it was not surprising that he warmed to the attentions of this coach, whom he called Papa.

At first, Papa seemed to offer Duncan the love and support his woefully indifferent and inattentive parents could not. Papa took him to museums, bought him presents, took him to the beach most summer weekends, and seemed interested in his interior life. After these early grooming behaviors⁴, the sex Papa introduced seemed a welcome expression of his love. Only with time did far more malevolent and disastrous aspects of their relationship emerge, but even then he continued—and continues—to love his coach.

After months of using bewildering euphemisms, he finally conveyed to me over a series of sessions that not only had he engaged in frequent sex with "Papa," his so-called adoptive father, but he was led mto drugs and prostitution. He was pimped out four or five times a week for about four years as part of Papa's teenage prostitution ring. He spent part of the week with other boys in an apartment Papa rented for them and slept in his parents" home no more than once or twice a week. He attended school only occasionally, but the school never told his parents he was truant and promoted him with the mediocre grades he managed to attain. His mother and father seemed relieved that his coach was willing to have him stay over so frequently, apparently never questioning Duncan's explanations about practicing late and then needing to get to practice early the next day. They never inquired much about where he spent the weekends.

This grandfather, who could not bear to touch his grandchildren, choked out the word "prostitute" when referring to himself, crying and muttering about what a "shitty little kid" he had been. Session after session, I felt an increasing loss of equilibrium as more details emerged. I was sickened when I returned home after seeing him.

Papa bought drugs for the boys. They got high together, they had sex with one another, and they went on their escort calls when Papa told them to. Each boy got a little pocket change for his services and occasionally a gift from a john. Sometimes they cruised the streets on their own to pick up tricks for drug money so they could party among themselves.

I certainly had heard of prostitution rings made up of teenage boys. But I thought of these as mostly comprising of runaways, not a boy who continued to live the remnants of a conventional middle-class life. I was no doubt naive. In any case, I did not want this to have happened to a man I was beginning to like and appreciate.

In the back of my mind I wondered where his parents had been in all of this. I thought about raising my own children, how I would have reacted had a teacher invited one of them to stay over, not once, but countless times. Could I ever not have known if one of my children did not attend school more than once or twice a week? But then, I could not imagine going on a winter vacation for weeks at a time leaving my 12-year-old without supervision.

Lest I get too smug, however, I recall an incident in the late 1980s when my son was at sleepaway camp. His counselor seemed like a perfect role model, an outdoorsy young man with a big body, open face, and heartwarming interest in each boy's individual needs for the summer. I was shocked when another boy accused the counselor of sexual abuse. Like the supporters of many accused pedophiles, I did not believe the accusations could be true. Then there was a second accusation and the young man was arrested and eventually convicted of gross sexual assault. This counselor did not abuse my son, but if things had gone differently, I might never have guessed if my son was traumatized but unable to disclose what happened.

Nevertheless, I began to get internally angry with Duncan's parents. I saw them as cruel, uncaring, or essentially clueless. Duncan's belief, which I could hardly refute, was that they simply hated him.

So I started to ask more about his parents, and learned about another level of abuse, one that arguably prepared Duncan to be receptive to Papa. He described his father as a near-cipher, rarely speaking or giving opinions, retreating into his office to read, never curious about Duncan. His mother, on the other hand, emerged as publicly charming, vivacious, and obsessed with how she and her family appeared to the outside world. But within the family she was caustic, vicious, domineering, with little understanding of children, especially boys. She increasingly focused on Duncan as an evil child whom she was determined to control and bring to heel.

In addition, there was a level of sexualization in the mother-son relationship that amounted to covert sexual abuse. For example, up until he was about 10, Duncan's mother would come into the bathroom while he was in the bath (she did not permit showers), and inevitably say he had not cleaned himself properly. She would then scrub him with an uncomfortably abrasive touch, including his genitalia. If he got an erection, she flicked it stingingly to make it go down, muttering how disgusting he was.

Obsessed with his bowel movements, she would give him enemas after his bath at least twice a week, forcibly, painfully. One night he was getting an enema while lying on his bed, and they got into an argument that led to her to hit him with the enema hose, not realizing it would dislodge from his rectum and spill fecal matter over the bedspread, Duncan, and her. (Rarely a man who smiled, Duncan looked wryly gleeful as he recounted this.) She began to scream at him in earnest and he dashed into the bathroom, holding the door closed by lodging his feet against it. She pounded on the door, screaming about the beating he was going to get. Her shrieks were so loud that they got the attention of his usually oblivious father, who was downstairs reading. For once, his father took control, telling her to leave the room, which she did while warning him not to clean anything up, that the filth must remain there until Duncan scrubbed it down. But his father did clean the bedroom, comforted Duncan, and helped him wash the bathroom. The enemas ceased at that point.

Hearing these stories, I began to hate his parents. Yet the stories also helped me understand how vulnerable Duncan was to a man who seemed to care about him.

Duncan felt, and still feels—albeit ambivalently—that Papa loved him and would never let any harm come to him. But eventually, he revealed holes in his loving narrative. Papa introduced Duncan to a man who enticed Duncan to visit him at home. There, two men he called "the bodybuilders" got him drunk and drugged him, then took turns raping him, taking movies while a small audience watched. He was ordered to return every week. Having seen how vicious these men could be, and believing that if he disobeyed they would come get him and make him suffer all the more, Duncan went back every week for many months.

It is difficult to fully understand why a boy like Duncan would return to sadistic abusers. The power a vulnerable child attributes to a dominating predator—especially one who has groomed his victim skillfully—can be vast. I have heard similar stories from other men who later blamed themselves, as Duncan did, for their own violation.

Over many months, Duncan painfully described escalating acts of degradation and torture. He often started by saying, "I can't explain it...," then tried to depict sexual assaults without really saying what he was talking about. Finally, all the while saying he could not explain it, he began to describe what happened. In bits and pieces, more of the story emerged as he opened dark recesses of his memory. My stomach roiled at what he illuminated. Like Duncan, I find myself wanting to use euphemisms for some of the things he disclosed. I strain for Latinate words rather than using short, shockingly evocative ones to convey what I was bearing witness to: He was forced into bestiality with large dogs. He was tied up and hung from the ceiling by one leg with weights hanging from his genitalia. He was forcibly masturbated almost to climax again and again. He had an electric probe or cattle prod inserted in his rectum. He was shown movies of his own screaming reactions to these prods. He was then told the prodding would be repeated if he did not obey. Then, with a gun pointed at him he was forced to rape younger children. All of this was filmed.

These images remain etched in my psyche. I was appalled as I listened to him, appalled when I wrote these words, and now appalled as I see them on the printed page.

Duncan similarly felt sickened by what he had done. Over and over, he called himself, "A shitty, dirty kid."

Horrified and convinced he was a child molester, Duncan wondered whether these younger children even survived. When I said he was the instrument of the children's torture rather than the torturer, he replied, "I destroyed kids even though I was forced. I don't like to be the guy who pulls the lever on an electric chair. Just as my soul has been trashed, I was instrumental in the trashing of so many other kid's souls. I feel like an animal at times."

Awake or asleep he was haunted by flashbacks of these children's faces screwed up in pain and terror. He described them in such detail that with time, those children's faces haunted me as well, long after Duncan left my office.

Yet at the time, Duncan felt he had no choice. He was sure that if he did not return every week to these men he would somehow lose his Papa's love, even though he continued to protest that Papa did not know about these tortures.

Now, however, he began to connect Papa to the devastating assaults. Co-existing and dissociated from his certainty that Papa could not have known what this other man led him to do was a new, growing conviction that Papa engineered all this torture. Still, he equivocated and struggled: "Maybe it was a coincidence that Papa was the one who introduced me to the guy. Or maybe he thought this man would treat me like Papa did—like he loved me. I know Papa would never want to hurt me. He was always careful about the Johns he took me to. They never roughed me up."

But then he remembered that some of the johns were indeed very rough with him, that sometimes there was bleeding and a visit to the doctor to be stitched up. He recalled that on one occasion the doorman in a john's building escorted him upstairs, stopped the elevator, and raped him before dropping him off for further rough sex.

Much later he mentioned Papa taking him to parties, said so offhandedly that I almost missed his words. But when I asked about these "parties," he revealed shamefacedly that he and perhaps ten other boys were brought there for the pleasure of a large group of adult men. The boys were dressed in girls" clothes and "auctioned off." The highest bidder took the boy into a private ...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• Acknowledgments
• Foreword: Personal and Conceptual Reflections
• List of Contributors
• Introduction: An Evolution of Ideas
• 1 Trauma and Countertrauma, Resilience and Counterresilience
• 2 Encountering Trauma, Countertrauma, and Countering Trauma
• 3 The Interpersonal-Relational Field, Countertrauma, and Counterresilience: The Impact of Treating Trauma and Dissociation
• 4 Words on the Ground
• 5 Sexual Thoughts and Feelings in the Countertransference: Can We Dance to the Music, Safely?
• 6 Point Counterpoint: The Paradox of Healing Traumatic Injury
• 7 Speaking to and Validating Emotional Truth in the Jury-built Self: On Therapeutic Action in the Psychoanalytic Treatment of Trauma
• 8 Growing Together: A Contextual Perspective on Countertrauma, Counterresilience, and Countergrowth
• 9 Lessons I Never Wanted to Learn
• 10 From the Holocaust to the Treatment Room: A Personal Journey
• 11 First Feelings: Countertransference Reactions in Disaster Mental Health
• 12 The Bristlecone Project: Transforming Survivors' Trauma and Despair, and My Own
• 13 Locked in with Amy: Treating the Dying Patient
• 14 Lessons Learned Treating Traumatized Teachers
• 15 Countertrauma and Her Twin, Counterresilience, and Why I Don't Watch Scary Movies Anymore
• 16 Academic Trauma: Indirect Experience, Far-Reaching Effect
• 17 Clinical Consultation to Help Transform Vicarious Traumatization
• 18 Colleague Betrayal: Countertrauma Manifestation?
• Afterword
• Index