Sunday, August 30, 2009

The Impact of Long-term Abduction and Sexual Abuse: The Jaycee Dugard Story

I was recently interviewed by a reporter who was interested in my assessment of the case of the recently found Jaycee Dugard, the 29 year old woman who had been the victim of a kidnapping at 11 years old, and who was held for 18 years in captivity by her abductor, a registered sex offender.   The abductor's chronic sexual abuse of Jaycee, which began shortly after her abduction, eventually led to the birth of two daughters, now aged 15 and 11 years old. (Click here to read the newspaper article.)

This case is one of immense tragedy and trauma.  Not only did this young girl have to survive the terror of abduction and the immediate loss of family and anything that was previously familiar to her, but also with the trauma that was to follow in the form of chronic sexual violence.

Tragically, the 11 year old Jaycee, who was held in the minds of her loved ones for those 18 long years, is long gone.  In her place is a now 29 year old woman who, for most of her life, suffered unspeakable sexual abuse and exploitation, and lived in unusual social isolation which robbed her of any reference of what was normal.  In the place of normal social and family experiences was the experience of being raised by a severely psychologically disturbed parent couple with a bizarre world view which included a distorted view of physical, emotional and sexual boundaries, justified through a bizarre religious belief system into which she was indoctrinated.

By instinct, Jaycee would have, no doubt, immediately become aware of the significantly vulnerable position she was in and that her life and survival depended on these two highly disturbed people.  As would be expected in a situation like this, she would have tried to find any modicum of safety she could locate, even if it meant that such safety would be located in her perpetrators.  This combination of extreme terror and dependence are necessary ingredients for the development of the Stockholm Syndrome.

The Stockholm Syndrome term emerged after a 1973 bank robbery incident in Stockholm, in which  bank robbers held bank employees hostage for about 6 days.  In this case, the victims were observed to become emotionally attached to their captors, and even defended them after they were freed from their ordeal.  The term Stockholm Syndrome has come to refer to the particular psychological response, sometimes seen in abduction cases such as Jaycee's, in which the victim forms an attachment to their perpetrators.  The victim, needing to find security and safety in a terrifying situation, projects into and identifies in the perpetrator the safety and protection she desperately needs to feel exists in the outside world.  By so doing, the victim comes to feel that she has some external safety as she connects to the perceived protective parts of the perpetrator, even while at the same time as she might be the victim at the hands of the same perpetrator.  The victim ultimately develops a complete psychological dependence on her perpetrator.  Abuse becomes fused with care. Such appeared to be Jaycee's experience.

Jaycee's identity has been shaped by and she is now permanently linked to this sick man.  She has borne two children by him who, no doubt, bear the scars of the sick life he imposed on them and their mother.  They are, however, likely to be deeply attached to the only life that they have ever known, a life that includes their father and all of his ideology.

One of the consequences of this kind of attachment in these kinds of circumstances, is that one is likely to see what appears to be contradictory behavior by the victims towards their abuser.  For example, it is possible that Jaycee may have felt positive feelings towards the perpetrator, negative feelings towards authorities or others who may have seemed likely to rescue or support her, or may have displayed support for the perpetrator's disturbed reasoning and behaviors.  It is possible that she engaged in supportive behaviors towards the perpetrator, at times helping him, and may have found herself unable to engage in behaviors that would have assisted her release or disengagement from him.

Now on release, she is likely to have overwhelming feelings of confusion and may continue to display these contradictory feelings and behaviors.  She may also experience significant feelings of guilt for having depended on her abuser and for her attachment to him.  Yet, the attachment that she developed must be understood as a normal part of a helpless victim's attempt to survive. 

So what now?  Now that Jaycee has been found and reunited with her family, how does she begin to mend her life?  The answer is, 'Very slowly and very carefully.'  Jaycee is likely to demonstrate symptoms of Post-Traumatic Stress Disorder.  Both she and her children are likely to demonstrate symptoms consistent with significant social isolation and extreme psychological dependence, as one often sees in those who have been long term members of a cult.  They will all need intensive, long term treatment and the family will need to be prepared for a long and complicated journey.  The joy of reunification will soon be followed by a range of emotions, not all of them pleasant.  The family would do best to protect these fragile, broken young people from the public's eye, so that they can commence their long road to healing. 

Thursday, August 27, 2009

When Bad Things Happen to Good People

Senator Teddy Kennedy was, by most accounts, a good man.  Yet, he had a life that was riddled with tragedies.  By the time he was 32 years old, he had lost all three of his brothers to violence and had lost the essence of a sister to a lobotomy.  He would later survive two near death experiences, one resulting in the death of another.  Two of his three children would battle cancer, one eventually losing a leg to it at the age of 12.

Bad things can happen to good people.  I say this to say that sometimes the things that happen to us may not reflect our innate goodness or our innate badness, they just happen.

From the moment that we recognize that when we cry as babies that we can make our magical mommy appear with breasts full of milk, we are encouraged into the idea of our omnipotence.  Yes, our earliest experiences rightfully encourage us to believe in our own power.  This experience, while vital in the development of  self-esteem, may also leads us to incorrectly conclude that we can control more than we actually do.  It is a sad state of affairs when the child has to come to terms with the reality that he or she may not have the wished-for power. The child comes to realize, for example, that she cannot make her annoying brother disappear, he cannot convince mother that he must have that special toy, or she cannot stop daddy from having another drink.  It is a developmental achievement for the child to continue to believe in his or her own power, even in the face of such disappointing and painful realities, but come to recognize the limits of it.

The child who survives infancy and childhood into adulthood psychologically intact does so by surviving these experiences and by accepting that which is the most difficult to accept - that we are often powerless over these events.  At the same time, the child must also accept that these life experiences are not a reflection of the child's innate badness or goodness.  Great things don't happen to the child because she or he is inherently good.  Bad things don't happen to the child because she or he is inherently bad.  Most importantly, the child must  believe in being inherently good and believe that she or he maintains her or his goodness, even when bad things happen.

To be sure, there are those who spend a lifetime trying to control bad things from happening, by trying to find ways that they can control the outcome of each event.  The fantasy is that they can keep bad things from happening by their own actions.   The woman who believes that she can be relieved of horrible feelings of dread should she wash her hands 17 times.  The man who must have his directions in all aspects in his life followed to the letter so as to make sure no unforeseen events occur and that the possibility of a bad thing occurring is controlled.  When they are not able to ultimately stop a bad thing from happening, they become excessively vulnerable to depression because they are unable to separate out the bad event from their definition of themselves.

Now, I am not arguing that we have absolutely no control over our lives.  There are choices that we can clearly make every day that diminish the possibility of a bad outcome.  Not drinking and driving is one of them.  Getting a check up with the doctor when one becomes ill is another.  What I am suggesting is that when bad things do happen, we could fall victim to depression should we entertain the idea that something about our being is  responsible for such a bad thing.  Belief in being 'cursed' or 'unlucky' reflects such an identification with external events that may reflect a belief in being inherently bad.

Healthy psychological adaptation means being aware of one's powerlessness in the grand scheme of things, while at the same time believing in one's own power.  Having belief in one's own power requires a belief in one's inherent goodness and sense of omnipotence borne from good enough early childhood experiences.  That is,  even when bad things do happen, we believe that we are made up of good stuff and that that good stuff can survive.

I suspect that that is how Teddy did it.

"The work begins anew.  The hope rises again,  And the dream lives on."  Edward Moore Kennedy (1932-2009)

Monday, August 24, 2009


Life can sometimes be likened to being on a train. Most of the time, it is going along quite well, getting to the appropriate destinations on time and without incident. Sometimes, it is a bumpy ride or there is some need for a diversion. On a few rare occasions, however, there can be a derailment that leads to disaster.

We are the train drivers of our lives. As long as we are in the driver's seat, we can have a clear view of what is in front of us. We can have clarity about where we've been, and can anticipate what stop is coming up next. We can be satisfied that we can have some reasonable control of the train, yet recognize that there might be some things that might occur, from time to time, that are outside of our control.

Sometimes, however, for some people, the ride is not always  a smooth one. In fact, for some, it is downright out of control. For children who have been the product of a chaotic early life, life can be described as the equivalent of being on a roller coaster train. A chaotic early life can result from the presence of parental alcohol or drug abuse, parental conflict, chronic parental disorganization or significant psychological difficulties in a parent. Unexpected childhood traumas, such as a life-threatening illness or the loss of a parent or sibling, could also contribute to an emotional upheaval. These experiences may leave a child with the fear that they are on a train that is going or has gone off the tracks, out of control. That is, the chaotic external life becomes the child's chaotic internal life. Sometimes, children raised in these situations become helpless, succumbing to a life of chaos and out of control behaviors. Others employ Herculean efforts in an attempt to bring some order to their otherwise chaotic experience.

They try to exercise CONTROL.

Think of the following examples. The young boy of the alcoholic parent who spent much of his young life making sure his mother was put to bed at night after an alcohol binge, or who would have suffer her rages throughout the day as she cursed him and everyone else in the world. The young girl who experienced abuse in early life and did not feel protected or supported by her family. Both of these children may have had the experience of feeling like they were on a train that was going off the tracks. While children like them may later live in an adult life that reflects derailment, others may work in an excessively disciplined way to correct the course and get their train back on track.

That person might become the adult who emerges from these situations paying very close attention to keeping things under control. Behaviors such as restrictive eating, excessive stinginess, perfectionism, obsessive cleaning, rigidity of personality or other ritualistic behaviors might reflect an attempt to bring order to what would otherwise feel like a chaotic world.

The fear for the now adult is that the train could go out of control, go off the tracks, but for the vigilance and CONTROL of the driver. The driver must apply the brakes, swerve hard, and avoid disaster.

Sometimes however, being chronically fearful of the possibility of the train going off the track, (or one's life going off track in some way) or being finely attuned to any slight bumpiness, the driver spends a lifetime with his or her foot on the brakes, and swerving from left to right. This 'over-correction', a response to the feared out-of-control train, ultimately leads to a train that is at risk of actually going off the tracks. That is, paradoxically, the attempts to control the feared out-of-control train, may itself lead to an out-of-control train or a train wreck. A person, fearful of becoming or feeling out of control, may ultimately engage in damaging out-of-control over-controlling behaviors.

For example, Gabrielle, a survivor of a chaotic early life, struggled with chronic anxiety and fears of her life becoming out of control. She has spent a lifetime over-controlling her food intake with the unconscious fantasy that, by so doing, she could free herself from the feeling of being out of control. Paradoxically, her attempts to control her out of control feelings resulted in an out-of-control eating disorder.

When thinking about your own controlling tendencies, pay close attention to what might be behind the need for such control. Remember that controlling behaviors emanate from fears of being out of control. Think about what is really out of control that might require inflexibility in relationships, spotless cleaning, or rigid rule bound behaviors. Do your attempts to correct your course ultimately lead to something else out of control? Is your train really out of control or do you just fear that it might be? Are your attempts at correction appropriate to the actual deviation of your train, or do you risk derailing your train by overreacting and overcontrolling?

Friday, August 21, 2009

Monitoring Behaviors in Romantic Relationships

I recently overhead a conversation between two young women. "Oh my God. This guy that I have been going out with is totally commenting on my Facebook every five minutes and, like, asking questions about everyone of my friends." Without skipping a beat, her friend proclaimed, "Stalkerrrrr!"

Monitoring behaviors in romantic relationships are not new. They involve a pattern of behaviors of closely monitoring the proximity of the person of interest. This can include a monitoring of not just the physical proximity of the person, but also a monitoring of the mental and emotional proximity.

"Where are you?" "Who are you with?" "Are you thinking of me?" These are all questions that may have the aim of ensuring an ongoing link with the person of interest. This relationship style represents not only the insecurity in the current adult relationship, but research indicates that it might reflect the person's early childhood attachment relationship. Specifically, monitoring behaviors in romantic relationships may reflect an anxious attachment of early childhood.

John Bowlby, a British psychoanalyst, originally developed the theory of attachment based on his observation that infants go to extraordinary lengths to either prevent separation or reestablish proximity with a parent. He argued that these were adaptive responses to separation from someone who provides support, protection and care.

Securely attached infants tend to be the most well adjusted. These infants have had the experience of relatively consistent and reliable parenting with few significant stressors or traumas in their early life. They tend to be resilient, well liked and get along well with peers. On separation from their primary attachment figures, they do become upset, but when the parent returns, the child actively seeks the parent and is easily comforted by him or her. In adulthood, these people tend to be more satisfied in their relationships and their relationships are characterized by greater longevity, trust, commitment, and interdependence. They easily turn to look to their relationship for comfort in times of distress.

In contrast, when trauma, inconsistency, abandonment or other significant stressors are a part of the infant's early experience, a different kind of attachment relationship can emerge.

Avoidantly attached infants tend to avoid expression of distress upon separation from their parent, although they are seen to be experiencing physiological distress. Upon reunion, these infants actively avoid seeking contact with their parent, sometimes turning their attention to other objects instead. In adulthood, these people may appear not to care too much about close relationships, and may prefer not to be too dependent upon other people or to have others be too dependent upon them.

Anxiously attached infants tend to become ill-at-ease on the initial separation from the parent, and then become extremely distressed. When reunited with their parents, these children have a very difficult time being soothed, often exhibiting conflicting behaviors that suggest that they want to be comforted, but also that they want to "punish" the parent for leaving. In adulthood, these people may tend to worry that others may not love them completely, and be easily frustrated, anxious or angered when their needs for connection go unmet. This is the attachment style that can lead to excessive monitoring behavior in adult romantic relationships.

Do you know your attachment style?

Secure Attachment Style
I find it relatively easy to get close to others and am comfortable depending on them and having them depend on me. I don't worry about being abandoned or about someone getting too close to me.

Avoidant Attachment Style
I am somewhat uncomfortable being close to others; I find it difficult to trust them completely, difficult to allow myself to depend on them. I am nervous when anyone gets too close, and often, others want me to be more intimate than I feel comfortable being.

Anxious Attachment Style
I find that others are reluctant to get as close as I would like. I often worry that my partner doesn't really love me or won't want to stay with me. I want to get very close to my partner, and this sometimes scares people away.

Thursday, August 20, 2009

On Becoming a Couple

Some people just struggle in relationships. They just do. There are a few that can't quite seem to manage to begin them, and there are those who just can't seem to manage to sustain them. If you are one of the folks for whom this is true, here are a few things to think about.

Our very first relationship experiences form the template for our future relating. Beginning from birth, our relationship with our primary caregivers is critical to our concept formation about relationships. These early life experiences of disappointment or satisfaction mould our image of what a relationships should or could be.

As a psychologist who often works with couples in psychotherapy, I find that helping individuals become aware of what they bring to a potential couple relationship is critical in helping them work through of the couple's difficulty.

For example, who could compete with Fiona's vision of the 'perfect' father she imagined her father to be and who would ever measure up to the critical analysis of her mother?

Dane could never let anyone get too close to him, but he would find that he often felt desperate and needy in relationships. His father had left the family when he was two years old, and his mother vacillated between being depressed and angry.

Neither Fiona nor Dane was conscious of being impacted by their relationship with their parents, but neither one could sustain a relationship. It was not until they began to understand how they would consistently re-enact the templates from their early life relationships in every relationship, could they begin to make different choices which led to more sustained relationships.

If you are struggling in forming or sustaining current relationships, it would be important for you to understand the impact of your early life relationships and the messages about yourself and others that resulted from that experience.

Here are five tips to help guide you through the relationship process.

1. Get to know yourself, including what your fears and hopes are in relationships.
2. Make a map of your family, and identify the quality of the relationships between the family members.
3. Ask yourself the following question: Do the feelings in my relationship remind me of anything in my early life?
4. Remember that communication is key. This may be hard for those who were raised in families that didn't communicate well and this may require extra effort.
5. Don't be afraid to seek couples therapy to address concerns in your relationship.

Wednesday, August 19, 2009

Have you heard about Executive Function Disorder?

The concept of ADHD, Inattentive Type, is changing! The understanding of inattention is shifting from the inability to stay on task to a broader concept called Executive Function Disorder (EFD). This acknowledges that the inattention often seen in children with this diagnosis can sometimes reflect a broader set of executive functioning difficulties. Keep posted for more information about this potentially new diagnostic category.

Remember, the best way to get your child properly diagnosed is with psychoeducational testing. Please feel free to contact my office to schedule your child for testing. You can go to my website at for more information.