Depression Dialogues 4: Dr Michael Corry looks at how sexual abuse leads to self-loathing
The emerging self, with its inherent potential, needs to be protected and, like a seedling, nurtured in fertile ground.
Sexual abuse, like no other trauma, eclipses this natural unfolding with an impact of such magnitude that is rarely appreciated. Upwards of 150,000 adult women and men in Ireland have experienced statutory rape in childhood. Five times that figure experienced other forms of sexual abuse, ranging from inappropriate touching to the forced witnessing of exposure.
Picture an infant, whose window on the world is the rim of their cot, whose cry or smile elicits the unqualified, unconditional attention of her mother and father, their watchful eyes holding her gaze completely, making her feel, for those moments, the absolute centre of the world. In the infant's tiny mind an inner knowing is forming - "I have made this happen."
Now put yourself in her tiny shoes and fast forward to a time when the same apparently loving father is gradually beginning to express his 'love' in a sexual manner involving you in sex games, which evolve over time into full sexual intimacy such as that shared by consenting adults. Your protestations are mollified, your co-operation validated and your secrecy rewarded. Variations of this premature sexualisation occur. Not for some fathers the process of seduction, but rather sadistic brutal intercourse instilling terror and pain, where every orifice is violated. You have no escape.
Drunk or sober, day or night, he has access to you. Your reason for living has been reduced to being a sexual object, a sex slave. Once again, and in both examples of fathers, the belief holds - "I have made this happen." The same interpretation will be formed if the attentions are those of a grandfather, uncle, sibling, neighbour or babysitter.
Fast forward again. You are now a teenager, perhaps at this stage no longer being actively abused, you now live a secret life besieged by guilt, shame, depression and self-loathing. School life becomes meaningless. Recreational drugs and alcohol bring anaesthesia. Suicide - the ultimate escape - is always on the agenda.
Frequently, early sexual abuse can be of such overwhelming intensity that the immature mind buries it beyond awareness in the deepest recesses of the unconscious. However, this powerful energy cannot be fully sealed off. The mental turmoil within may see you engaging in complex obsessive-compulsive thoughts and rituals - hours scrubbing your body in the shower, frequently washing and changing your clothes, engaging in checking routines and endless mental scrabble, without knowing why. The imposition of order and self-discipline quells your anxiety. You may withhold food through calorie counting and starvation rituals, and engage in self-mutilation practices for release of tension.
In adult life, abuse may express itself primarily as depression. It is depressing to have intimacy problems, to fear touch, to feel confused about your sexual identity, to repress and feel shame of the self as a sexual being. It is depressing to be haunted by images and sensations that you can't explain; such as feelings of stubble against your face, the pressure of body parts against yours, and the pervasive smell of alcohol and sweat.
Over the years you come to loathe and despise yourself for these peculiarities, holding your personality responsible. Why wouldn't you? There doesn't seem to be any other explanation. "It must be me, I must have a sick mind."
Boys do not escape. Those who were incarcerated in industrial schools have borne witness to this. Many were exposed to regimes of unbridled rape and violence which lasted for years, at the hands of sadistic sexual perverts answerable to no one. Their threats of unspeakable violence ensured availability and silence.
The majority of survivors - their chance of a normal life diminished from the beginning, with their lives totally derailed, and their humanity denied - learned to place no value on themselves. They drifted from one crisis to another, their past littered with criminal behaviour, prison records, substance misuse, dysfunctional relationships, mistrust of authority and family breakdown.
Powerless to bring stability to their lives, many suffered from depression and other serious psychiatric orders, beginning a life-long relationship with mental hospitals.
The greatest tragedy of all is that this population feel robbed not just of their innocence, but of their inner light, as if their very soul has been taken away. I have worked not just with survivors of abuse in the industrial schools but also with those who fell victim to the predatory behaviour of priests in certain boarding schools who lured them in, on the basis that they were intelligent, 'special' boys with spiritual potential, needing guidance with their sexuality.
The 'guidance' offered was in fact a gradual seduction process, which commenced with the exploration of things sexual, stimulating their curiosity, providing skewed answers and finally grooming them towards the acceptance of mutual touching, masturbation and penetrative sex. To this day, married or single, many are haunted by flashbacks of their abuser's body odour, the taste of their sperm, the very touch of their fingers, the sound of their voice and the image of their presence. The experience was encoded not just in consciousness but in cellular memory where it can be triggered into life and relived in an instant, such as, paradoxically, during sexual intimacy with their partner, when the image of the first seductions by their abuser intrudes, causing avoidance and sexual dysfunction.
The sexually abused are truly the walking wounded, living out private hells, their lives irreparably shaped by the experience. Behind the mask of many a so-called 'biological' or 'clinical' depression lies a history of sexual trauma which cannot be dissipated by a pill or a course of electric shock treatment. This is the domain of psychotherapy. The painful process of peeling back the layers of trauma within a psychotherapeutic relationship, so that they can be truly seen, verbalised and integrated, is a lengthy one, sometimes without any satisfactory resolution, so all-pervasive is the damage.
To compound matters, there are numerous and formidable barriers put in the path of the abused in their quest for recognition, the result of which is to protect the perpetrators, minimise the extent of the abuse, and its life-long and far-reaching effects. This denial and disbelief not only re-traumatises victims, blocks restorative justice, but also impedes their healing process. Another more subtle obstruction to this healing is the failure on the part of doctors in so many cases to link depression with trauma of this kind, diagnosing it as a 'new' illness, the treatment of which bears no witness to its root cause.
•Dr Michael Corry is a consultant psychiatrist and co-author of Going Mad? (Gill and Macmillan) with Dr Aine Tubridy.
• Depression Dialogues is a series of open meetings with all members of the public welcome. Each meeting will be facilitated by Dr Corry, and will be held on the first Thursday of each month. The next meeting is scheduled for Thursday in the Jury's Hotel, Ballsbridge at 7.30 p.m. to 9 p.m. Donation €8. Enquiries 01 2800084. A website www.depressiondialogues.ie is currently being designed.