Bobbi’s Saga: Hitting a Brick Wall, Running with No Place to Hide

CAUTION: TRIGGER WARNING. Contains descriptions of sexual and physical abuse. Please read at your own discretion.

“The assault stole my soul.  I became a sneaky person.  I kept the secret of my rape. I carried the secret for 40 years before telling anyone. I was mad, ashamed, and disgusted with myself. I lived in fear that someone would find out about my secret.”

“The booze kept her demons at bay.”

–        Bobbi’s remarks about the movie Respect (2021).

“I got demons too Ree. Would you help me fight mine? …. and I will help you fight yours.”

–        Scene from Respect (2021). A plea by Ree-Ree’s (Aretha Franklin) husband following his physical assault upon her.

“There are no demons … it is the pain you have been running from your whole life.”

–        Scene from Respect (2021). Statement by Ree-Ree’s pianist to her at a highly emotional moment.

“I thought about killing myself.  I did not because of the pain I would leave behind.”

–        Bobbi’s statement restated recently which was made 10 years ago.

My Dear Readers,

In writing this blog, I want to attest, recognize, and acknowledge the recent activities of Suicide Prevention Week September 5th – 11th, 2021. There are those among us who may seek to end their lives.  They are often judged, criticized, and frequently misunderstood.  No one knows how much an individual can endure before they finally lose hope.  I choose, rather than to judge or criticized, to have empathy and compassion. Show human kindness for their long-suffered pain. It is my hope that the empathy, compassion, and human kindness shown to someone in pain becomes a model for, and appreciated by, others outside of clinical or therapeutic environments.

In writing about Bobbi’s Saga, I have sought to tell her story and in doing so provide clinical insight into the work that we have been doing.  Bobbi, a pseudonym used to protect her confidentiality and privacy, is only one of many sexual assault victims, females, and males, that I have worked with in the African American community.  These individuals, both young and old, have suffered in silence; a silence of shame and trauma that has been reinforced by the community’s demand to keep quiet and protect the image of the adults, family and community that is bonded by 400 plus years of depravation, degradation and deeply held self-hatred.

Bobbi has been my patient for approximately 10 years. I have sat with her over hundreds of hours, listening to her story as her pain ascended to the surface of her emotional landscape. There have been times in which recovery seem possible and others in which the therapeutic work seemed to hit a brick wall.  This blog is the result of hitting that brick wall.

During the last two months of therapeutic contact, namely sessions twice weekly with phone calls and emails 2-3 times per week, Bobbi acknowledged that she was at a point in which she could go no further and seriously questioned the possibility of suicide.  As the question of suicide was constant in every session for the previous four weeks, I felt that unless there was a drastic, direct, and immediate intervention, all hope for Bobbi’s possible recovery was coming to an end.

For those unfamiliar with Bobbi’s horrific saga, at the age of 4 years old, while left home to babysit her 2-year-old brother, she was viciously raped by the building’s landlord. Upon his threats of killing her mother and brother, she stayed quiet regarding her assault.  Then at the age of 9 years old and for the next three years she was repeatedly raped by her stepfather.  Once again, she kept the “secret” and it was only until after achieving her first period and being told by her stepfather that she was going to have his child, she finally gained the courage to tell her mother.

Rather than protect Bobbi, her mother physically assaulted her and threatened to blind Bobbi with a fork. Following Bobbi’s attempt to defend herself, her mother threw Bobbi out, at the age of 12, into the street and reported to the state authorities that she was “incorrigible”.  Bobbi went on to spend the next 6 years moving around the state foster care system, aging out at 18.

During her later years in adulthood, Bobbi learned the lengths her mother would go to protect her “reputation and image” within the local African American community.  Bobbi learned that her mother had gone to the state welfare authorities to “claim” the intake documents in which Bobbi identified her stepfather as sexually assaulting her.  When this was foiled, her mother began a campaign within her personal circle and church community to tarnish her daughter’s reputation, alleging she had put her out because Bobbi had defied her and attempted to strike her.

The strategy of Bobbi’s mother was well conceived.  During this time (and it continues today) African Americans were forced to tolerate a complete lack of respect from white people so the idea of not receiving respect from people within the community was unacceptable.  Furthermore, the idea that one’s child would raise her hand against the parent was inconceivable.  Therefore, in telling this one-sided story, Bobbi’s mother won “acquittal” in the court of public opinion within her community of being a “bad mother” and justified in tossing her daughter into the state foster care system.

Bobbi’s mother rejected her; the mother’s friends and the community in which Bobbi was raised also turned their backs on her.  However more betrayal was forthcoming.  Later, as an adult, Bobbi learned that her mother for whatever reason, turned against her husband and wrote a letter to the Senior Pastor of their church, formally notifying the church hierarchy of the three years of rape/incest by her husband against Bobbi.

The stepfather, at the time of the assault, was a senior member of the church’s Deacon board.  It is known that both the Pastor and the Deacon Board had knowledge of the acts and met to discuss the formal letter and took NO ACTION against the stepfather nor did they reach out to provide resources to Bobbi.  There was no formal response to the letter. Why? Why remain silent, why protect the stepfather?

Why not protect the children of the church? As a member of the deacon board, the stepfather has access to the children through church related activities. The answer is simple …. Protect the reputation of the church at all costs even at the expense of one of its youngest, most vulnerable members.

The way Bobbi was sexually abused, the physical assault by her mother and the abandonment by her community and church has triggered within Bobbi not only her downward spiral over the last 50 years it also reinforced her shame and disgust towards that nine-year-old girl who endured the sexual abuse in silence for three years.  Recently this self-disdain exploded when in session, Bobbi acknowledged she wanted to beat on the little girl for keeping quiet and not doing anything to stop the abuse. This statement, stemming from her pain, shocked Bobbi and resulted her deciding to take drastic steps to end it.

Drastic steps by Bobbi demanded direct and decisive intervention.  The traditional Western approach of having her committed to inpatient psych care would have me as her therapist following correct measures to protect Bobbi from self-harm however such action would be temporary as the main issues of self-loathing, abandonment, and the unwillingness to forgive the nine-year-old child within would continue until Bobbi had achieved a final resolution.

(The remainder of this writing is descriptive of the direct and decisive intervention part of which included Bobbi, accompanied by Dr. Kane, attended a viewing of the movie Respect (2021). It is the story of the life of Aretha Franklin. The writing will feature journal entries pre and post review of the movie, followed by clinical insight and conclusion provided by Dr. Kane)

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Bobbi’s Saga

Journal Entry: Thursday, 09.02.21

“It is the evening following the session with Dr. Kane.  He discussed our attending the movie Respect and discussed the safety protocols designed to keep me safe. The plan is to have a debriefing session following the movie at Dr. Kane’s office.  I am extremely anxious; it is now almost midnight. I have tried to keep busy, but my mind kept wondering what [will be] in the movie.  Dr. Kane thought it wouldn’t be a good idea to talk about the movie in today’s session. I appreciate all the help, support, energy, and time Dr. Kane is doing to make tomorrow’s intervention happen.”

“Today, we also talked about suicide again.  I felt like I need to hear what to do again. We went over all the steps including calling the crisis clinic.  Yesterday, suicide was on my mind so much.  I was terrified of myself.  I was disgusted, depressed, anxious, and scared I might do something bad. I have all these thoughts of ways to carry out the suicide.”

“I was feeling so ashamed.  I have so many things to be ashamed of.  I wish I could believe that there was nothing I could have done about the rapes.  I was 40 pounds, and the landlord was 200 pounds.  As to my stepfather, he knew what he was doing was wrong, but he convinced me otherwise.  I was taught to believe and trust adults.  He said my mother wanted me to do these things.  I believed him; I wanted to make my mother happy. I feel ashamed about the sensations, even if they were automatic.”

“Tomorrow is the movie.  I am anxious and don’t know what to expect.  I am going to go to bed now and pray for tomorrow.  It is going to be difficult to sleep.  I want to sleep and be rested for tomorrow.”

Journal Entry: Saturday, 09.06.21

“I am writing up yesterday’s session. I had wanted to do this last night, but I was too overwhelmed and exhausted.  I took some medication and was able to sleep for five hours.  Yesterday was an intense day.  We had a session at Dr. Kane’s office prior to leaving for the movie. He reaffirmed yesterday’s discussion that I could walk out of the movie anytime I become too anxious.  We acknowledged that walking out into the hallway didn’t mean I was ready to leave the theater; it meant I needed space or time to respond to my anxiety.”

“Dr. Kane also restated that I could leave and return home at any time. Furthermore, he had agreed that we would have a post movie session at his office.  Prior to seeing the movie, I was already so anxious as I couldn’t imagine what could be in the movie about a singer. I felt so anxious inside that my stomach was flipping.  I hadn’t been normal.  I had been crying about this.  But I was willing to the movie if it was going to help me.  I was having extreme anxiety.”

“When I saw the man in the movie say to a young Ree-Ree (Aretha Franklin) ‘We can be friends’ and then shut the bedroom door, I knew bad things were going to happen.  I can recognize scenes like that in movies before they happen.  It also sends a trigger to me of the first time I was sexually assaulted. Ree-Ree was about the same age I was when it started. She had that look of innocence.”

“The next scene in the movie in which her grandmother keeps asking her, ‘What happened? You know you can tell me anything.’ Ree-Ree still denied anything had happened.  That also was like me.  There was nothing my mother could have said to me that would have [made] me tell on the landlord.  I was protecting her and my little brother.  Loving her cemented my inability to tell what the landlord had done.” 

“Love for my mother and fear of the landlord cemented my lips.  I would keep that secret for over 40 years. The secret made me become a frightened, guilty, ashamed, isolated child. I was always afraid, alone, isolated, and secretive.  I kept the secret long after the landlord was dead.  Keeping the secret made me unhealthy and anxious.”

“When I saw Ree-Ree in the movie, you could see the changes in her following being raped.  Her childhood was gone [along] with her senses of joy, peace trust and love now replaced with guilt, shame, anxiety, fear, loneliness, and ongoing thoughts that it is going to happen again as well as extreme depression and questioning if life is worth living.”

“The next scene in the movie that made me gasp, hold my shawl and use it to wipe the tears running down my face.  It was the scene that Ree-Ree, a young child dressed in maternity clothes.  She looked like a child, had the face of a child but she had clothing that you could tell she was pregnant. As I saw the scene, the thought kept screaming in my head! She wasn’t singing.  Her pride and joy in herself and singing was gone.”

“I kept crying and hearing the screaming in my head ‘that could have been me, that could have been me.’ I recalled that when I told my mother that I had started my period, she had told my stepfather.  I was at the top of the stairs getting ready to come down. He said “Your mother doesn’t want to have any more children.  Now you and I can have a baby.”

“I didn’t reply.  That was the worst thing to hear.  I quickly walked down the stairs.  I was terrified.  I remembered thinking no one would believe me.  I knew that no one would believe the baby was his.  He will deny it.  I knew I had to leave before it happened.  I knew I had to go.  I didn’t know where.  I had no one who loved me.  Not even my mother.”      

“I cried through a lot of the movie.  Dr. Kane asked me repeatedly if I was okay and if I wanted to leave.  I said no.”

“The movie goes on to Aretha as an adult.  She had severe depression and often thought of the abuse as a child. It affected her adult life. She called the past thoughts, her demons.  They invaded her life and made it sometimes impossible to sing.  Her songs had lyrics of abuse and sadness. Some songs lyrics were full of what she wanted and yet did not have in her life.”

“Aretha’s father controlled her life.  He controlled what she sang, how she dressed and her behavior.  Her first husband who was a copy of her father did the same thing.  She eventually found the strength to speak up and stand up for herself….to love herself.”

“I felt so sorry for little Ree-Ree (Aretha).  All this time I didn’t think of being sorry for the little girl in me.  The little girl that had all the pain and shame; having to keep it a secret.  Being scared, the young part of her life that someone would find out and think and see her differently.  Then scared later in life that someone would find out and her shame would increase. Being fearful, that people would think she was a bad person, and it was her fault.”

“On the ride returning to Dr. Kane’s office for the post-movie session, I still had tears rolling down my face.  I kept thinking of the scenes in the movie that reminded me of my life. I kept reflecting on the rape, pregnancy, demons following her.  I kept thinking about the depression, the changes after the rapes and the demons that followed her for most of her life.”

“At the post session, Dr. Kane restated the progress note questions.  Then we discussed how my life reflected the movie.  I cried and talked about my pain, flashbacks, and memories.

  • I spoke of the memories of having objects pushed inside me
  • Being forced to do oral sex with his hands held behind my head
  • Being forced to gag as he pushed his penis down my throat 
  • Being told by him to rub my chest daily to make breasts grow
  • Trying to scream while the landlord was covering my mouth
  • Thinking I was going to die, wanting to die
  • Suicidal thoughts and old thoughts of how to commit suicide.”

“I left the office after a short talk about the paintings and artwork in Dr. Kane’s office. When I got home and started thinking of Ree-Ree again, I started crying again.  I told my husband if he wanted to talk about today, he should ask me tomorrow as I am too exhausted now.  Today, he never asked or mentioned it.”

“I am still thinking about the pregnant little girl and how that could have been me.  I am still anxious it is over 24 hours.  Feeling such empathy for Ree-Ree has made me think about myself differently. I questioned ‘how could I have such empathy for a movie character and not have empathy for myself?’”

“I understood why Dr. Kane used the movie as a teaching tool.  I have had empathy for others but been extremely hard on myself. All these years I have been thinking that it was my fault.  Having a disconnect between feeling it was my fault and I now know there was nothing as a small child I could do against a grown man.”

“Now I hope I can control my intense suicidal thoughts.  I still feel depressed, anxious, and overwhelmed.  I know now that it is worth living.  I do not want to let my rapists win.  If I take my life, they will win long after the rapes happened.  I want to remember the flashbacks as demons. Panic attacks… I think I have been having panic attacks for the last two weeks.  I am having periods of rapid heartbeats, rapid breathing, and repeated sobbing.  I worry about my flashbacks as these can last for hours.”

“Dr. Kane made a comment in the session prior to the movie that he feared that I was slipping away.  I wonder what he meant by that.  I will ask him during the next session. One of the things I told Dr. Kane was I had never heard of loving yourself until I started therapy.” 

“Thank you, Dr. Kane.”

Complex Trauma

Complex trauma does not go away by

Simply pushing to the back of your mind

It is a thief that lurks around until it

finds an open door, a crack.  it flashes. It

screams as it leaps into your soul.

It is a thief that steals in the day or in the night

Enough is never enough

It steals and steals and steals

It plucks and sucks the life, slowly from me.

– Dr. Micheal Kane

Clinical Analysis – Dr. Kane

Intervention Guidelines

There are three audiences to which my comments are directed: 1) those who have endured sexual abuse; 2) the lay community who has interest in the topic of the psychological impacts of trauma regarding sexual abuse; and 3) colleagues, peers and students who are engaged in or seeking to engage in this important work within the Black, Brown, Indigenous and People of Color (BBIPOC) communities.

Attention has been given to balancing and contextualizing content and language so those not familiar would be able to follow the dialogue as well.  The clinical concepts, interventions, and protocols are based on my education, clinical training, consultation and most importantly the transformation (and not integration) of Western theoretical and therapeutic approaches into one that is based on a combination of feminist and multicultural orientations which are focused on the work of self-psychology and the self-relational psychotherapy.

As I begin the analysis, it is essential to state that the only changes made in Bobbi’s journal entries are the bullets points highlighting her sexual abuse from her 9/06/21 entry. This was an editorial decision made to give the reader an understanding of how the abuse impacted Bobbi.

The objective of my analysis is to provide clarity as to the intended outcome of the intervention as well as to address comments made in Bobbi’s journal entries. Bear in mind that this was not a traditional method of treatment but, it was one that was felt would benefit the patient and help her through her crisis allowing her an aid in processing her thoughts and feelings.

This method of intervention was chosen based on several factors such as:

  • What was the history of this patient’s life?
  • What was the impact of the sexual assaults, abuse, abandonment?
  • What has shaped the patient’s life to this very day?
  • What was the perceivable outcome of the current actions internalized by the patient?

These factors are unique to this patient and have been partially addressed in the introduction to Bobbi’s Saga and her current journal entries.

To ensure that the methods use were within the standards of ethical behavior, patient care and confidentiality was maintained and the following protocols were devised and followed.

  • Documentation of all levels of the intervention are recorded in the progress sessions notes
  • Mini mental status examinations were conducted prior to and following the intervention – viewing the movie Respect (2021).
  • Therapy sessions were conducted twice, within the confines of the known therapeutic environment prior to the intervention and immediately following. In addition, two following up telephone calls were in placed in conjunction with the follow up sessions
  • Protocols as to patient safety were devised (as follows):
  • The patient was informed of having the choice to remain or decision to leave the theater at any time
  • There were several means provided for the patient to communicate distress –
  • Numbering: One finger displayed (safe), two fingers displayed (concern), three fingers displayed (distress).
  • Verbal cues: Green (safe), Yellow (concern), Red (distress),
  • Verbal Statements & Movements: leaving the theater, relaxation exercise in the hallway or outside the theater or exiting temporally or permanently. All at the patient’s discretion.
  • Discretion of the therapist to stop the intervention due to either over stimulation or distress of the patient.
  • Patient confidentially was maintained.  No information or designation of clinical involvement of the patient.
  • Due to the intervention being a teaching method outside the confides of the therapeutic environment there were no fees charged.  Furthermore, the costs of the admissions for the intervention were paid for by the clinical practice.  Receipts and ticket stubs are clearly documented in the patient record.
  • Consultation via the consulting Trauma Group will be noted in the patient record.

Case Specifics

Bobbi’s case is complex. She is an African American female in her 60’s, she is responding to numerous traumas inflicted upon her during the developmental stages of early childhood, middle childhood, adolescence, early adulthood, middle adulthood and old age. Specifically,

  • Early childhood – raped by an adult at the age of 4 years old
  • Middle childhood – raped by stepfather from the ages of 9-12 years old
  • Adolescence – physically assaulted and abandoned by her mother, church, and community, placed into the state foster care system at age 13.
  • Early adulthood – aged out of the state foster care system at 18, disconnected from her family, marriage
  • Middle adulthood – raising her family; rapes and traumas left untreated, maintenance of the “secret” for 40+ years
  • Old age – grown children, parenting issues no longer the focus, rapes left untreated. Begins treatment.

The mistake that is often made is the assumption that trauma is simply trauma.  The reality is that there are 17 subtypes (along with 15 forms of racism) of trauma that people of African American descent are vulnerable to and can be exposed to daily and Bobbi has been exposed to the following subtypes during her life:

  • Intergenerational Trauma
  • Historical Trauma
  • Insidious Trauma
  • Racial Profiling
  • The Imposter Syndrome
  • The Stereotypical Threat
  • Betrayal Trauma
  • Micro-Aggression Assault
  • Macro-Aggression Assault
  • Just World Trauma
  • The Invisibility Syndrome
  • Complex Post-Traumatic Stress

Major psychological impacts resulting in extreme wounding of the psychological self, occurred during early childhood, middle childhood, and adolescence.  As Bobbi got older, she continued to carry the secrets of her abuse while simultaneously battering the inner child trapped at those three developmental stages. 

In the 40+ years that Bobbi has maintained the “secret” she, because of family and cultural mistrust of the medical community, has never sought treatment.  This may have been wise due to the likelihood of being misdiagnosis with a dissociative mental illness if she sought help from a professional who was not well versed in treating members of the BIPOC community.  (Dissociation can be defined as a mental process of disconnecting from one’s thoughts, feelings, memories and or sense of identity.) 

On the contrary, Bobbi has not lost connection.  It is the connection with her thoughts, feelings and memories that has been the foundation of her survival.  The one constant theme of Bobbi’s belief is that the child/ adolescent within all three development stages, could have done something to prevent the sexual assaults and therefore the child/ adolescent is responsible for the abuse and should carry the blame and shame associated with the sexual assaults.

During the last ten years in therapy, she has made progress through the stages along the journey of self-discovery (driving – empowerment, striving – setting pace and directions, and thriving – achievement of defined objectives and goals) and it has been my role using the clinical techniques of self-relational psychotherapy grounded in self-psychology, to be the guide as she progresses through life.  There have been times when this progress was rough and unforgiving. This is one of those times.

Towards the ending of one of Bobbi’s journal entries, she describes a comment made as:

“Dr. Kane made a comment in the session prior to the movie that he feared that I was slipping away.” 

Her comment was rock solid.  For the past ten years, I have worked alongside of Bobbi as she relived traumas, nightmares, and flashbacks.  Now that she has reached the developmental stage of “old age,” I was struggling to assist her to hold a safe place for the inner children of early and middle childhood as well as the young girl of adolescence. 

The issues here were complex. In one way, the adult woman knew that the child/adolescent was not responsible for the sexual assaults and the other abuses that she’d experienced, yet within her, were the demands of the child/adolescent to be held responsible, accountable and hold on to the shame, guilt, and blame of what others had inflicted upon her.

A major crisis occurred when recently, following weeks of consistent intrusions from the traumas and resulting psychological impacts from nightmares and flashbacks, Bobbi, the adult, begin to agree with the child/adolescent that they should have prevented the sexual assault and therefore were responsible for the acts and following abuses.

To make matters worse, following a recent session when I attempted to advocate on the part of the child/adolescent, Bobbi chided me both verbally and in her journal for being stern with her.  It was my concern that for the first time in ten years, we were going to be opposites as I sought not only to assist Bobbi during her difficult time but to aid her in finding the ABC’s (advocacy, balance, and calmness) for the three entities she carried within the psychological self.  The situation worsened when Bobbi exclaimed in session that she wanted to hurt or punish the child/adolescent for their roles in not protecting her from the sexual assaults. 

The situation then struck critical mass when Bobbi began reengaging in suicidal ideation and consequently planning for the care of her beloved animal following her death.  It was at this point I felt a sense of hopelessness that after ten years of difficult work, Bobbi was surrendering to her traumas and wounds.  In my opinion before my eyes, she was “slipping away”.

In this difficult work there are two groups of therapists, one who has lost a patient to suicide and the other who will lose a patient to suicide.  In my 35 years, I have lost two patients.  Both having done so after enduring years of extreme traumas, Bobbi would not be a third.

When working with Bobbi, there is the focus on balancing the “needs” and the “wants”.  Simply stated, needs are primal, essential for survival, fundamental. Whereas wants are secondary, grounded in growth and development.  As Bobbi is responding to “self” on three distinctive developmental stages, early childhood, middle childhood, and adolescence, two clinical concepts (among others) are constantly present within the therapeutic environment; transference and projective.  These two are defined as:

  • Transference – occurs when people redirect emotions or feelings about one person to an entirely separate individual.
  • Projective Identification – is a defense mechanism in which the individual projects qualities that are unacceptable to the self

Blocks, Hurdles etc.

There were several major blocks and hurdles impeding Bobbi’s movement within therapy.

  1. The consistent affirmation that she did not do enough to prevent the sexual assaults and the need to hold the child & adolescent responsible for the sexual assaults and resulting abandonment by the family and community
  2. The internal conflict of not being able to connect her mental awareness as an adult with empathy and compassion to inner child having endured the repeated sexual assaults
  3. The consistent shame, disgust, and disdain for self-regarding the sexual acts as a child she was forced into leading to the resulting solid emplaced beliefs that “I am a bad person” all of these held firmly despite the large amount of evidence to the contrary.

Despite therapeutic interventions by both Bobbi’s therapist and psychiatrist, who provided both medication management, adapted therapeutic intervention, as well as internet searches done by Bobbi attesting to the lack of responsibility in her abuse, Bobbi was adamant about holding the inner child at a distance and targeting the self with ongoing shame, blame and disgust.  All leading to the current downward spiral.

The Film… Respect (2021)

The reason for using the film Respect as a clinical intervention tool was because there was a need to develop a strategy from which the patient could benefit, utilizing the clinical concept of the I Factor, described below, which the movie provided.

  • Information – sharing of knowledge, wisdom, experience
  • Involvement – the internal shaping of what is being shared
  • Integration – the rooting/centering of what has been taken within
  • Implementation – the movement of what has been learned and experienced
  • Impact – the transformation into new knowledge, wisdom, and experience 

The objective was to assist her to voluntarily move from a state of need (survival) to a state of want (growth).  This would entail consciously letting go of the entrenched defenses and allowing herself to be vulnerable, exposed, and trusting (VETING) to new information. The film provided that push. Understanding the impact of the push and the means to access the psychological self was built on the clinical work, belief, faith, and trust (BFT), the patent had established with the therapist during the previous ten years of involved psychotherapeutic sessions.

Process & Protocols

The process entailed meeting the patient at the office, escorting the patient to the event, and returning the patient to the office to continue in the post session. This process was implemented to ensure patient safety because it was unknown how the patient would be psychologically impacted following observing the events in the film. The immediate follow up session after the film was designed to:

  1. Achieve a mental status examination
  2. Provide an opportunity for the patient to debrief, emote and decompress
  3. Provide emotional balancing as the patient distanced emotionally from what had been observed

The process included examination of the patient’s emotional fitness via mini mental status examination (PRE) prior to the film and another mini mental status examination (POST) following reviewing the film. Safety protocols, as stated above were implemented while watching the film.

During the movie, the patient remained nonverbal, non-communicative and appeared to be consistently in dept of thought, emotion, and processing.  She appeared to be consistently oriented to “X4”. Specifically, person, place, time, and situation.  I observed numerous emotional and tearful response, deep gasps, and a consistent and tight grasping/clutching on the shawl she carried which was used to either cover her face or wipe away tears as needed. After the movie and following the protocol, there was silence during the drive returning to the office allowing the patient the opportunity to process what was seen with the either emotional distancing or psychologically integration.

The Benefits of Visual Observation

Bobbi’s method of maintaining control was conflictive. While she sought to free herself of the pain, memories, and flashbacks she also sought to hold the inner child/adolescent at a distance and responsible for failing to stop the sexual abuses which ultimate led to her abandonment by her mother, church, and community.  Upon watching the film, she was unable to maintain the entrenched defensive distancing and allowed the psychological self to be vulnerable, exposed, and open to trusting what she was seeing and experiencing.

Post-movie Comments

Referring to Bobbi’s journal entry

  1. The issue of empathy – Specifically on the following quotes
  2. “Feeling such empathy for Ree-Ree has made me think about myself differently. I questioned how could I have such empathy for a movie character and not have empathy for myself?”
  3. “I have had empathy for others but have been extremely hard on myself. All these years I have been thinking that it was my fault.”

The observations and integration from the film allowed Bobbi, in seeing the portrayal of Ree-Ree, see herself and begin having the empathy for self which she had denied throughout her life.

  1. The issue of a child being responsible for her sexual assaults
  2. (Prescreening) “I wish I could believe that there was nothing I could have done about the rapes.  I was 40 pounds, and the landlord was 200 pounds.” 
  3. (Post Screening) “All these years I have been thinking that it was my fault.  Having a disconnect between how I feel it was my fault and I now know there was nothing a small child could do against a grown man.”

Outcome – Bobbi was able to not simply reject her long held belief of being responsible for the sexual assaults, she was able to transform these beliefs, cease accountability and punishing self for the actions of her assailants.

  1. The clinical concepts of transference and projective identification
  2. “I still had tears rolling down my face.  I kept thinking of the scenes in the movie that reminded me of my life. I kept reflecting on the rape, pregnancy, and demons following her.  I kept thinking about the depression, the changes after the rapes and the demons that followed her for most of her life.”
  3. “As I saw the scene, the thought kept screaming in my head! It was the scene that Ree-Ree, a young child dressed in maternity clothes.  She looked like a child, had the face of a child but she had clothing that you could tell she was pregnant. She wasn’t singing.  Her pride and joy in herself and singing was gone.”
  4. “I kept crying and hearing the screaming in my head ‘that could have been me, that could have been me.’ I recalled that when I told my mother that I had started my period, she had told my stepfather…”
  5. “I felt so sorry for little Ree-Ree (Aretha).  All this time I didn’t think of being sorry for the little girl in me.”  The little girl that had all the pain and shame; having to keep it a secret.  Being scared, the young part of her life that someone would find out and think and see her differently.  Then scared later in life that someone would find out and her shame would increase. Being fearful, that people would think she was a bad person and that it was her fault.
  6. (Grandmother) “You know you can tell me anything.” Ree-Ree still denied anything had happened.  That also was like me.  There was nothing my mother could have said to me that would have had me tell on the landlord. 

Outcome – Bobbi was successful in holding, balancing, and redirecting the themes of transference and projection identification

  1. Holding onto to life
  2. “Now I hope I can control my intense suicidal thoughts.  I still feel depressed, anxious, and overwhelmed.”
  3. “I know now that it is worth living.  I do not want to let my rapists win.  If I take my life, they will win long after the rapes happened.  I want to remember the flashbacks as demons.”

Outcome – Bobbi is now focused on control and was able to move toward the clinical conceptual stage of advocacy moving towards driving (empowerment), striving (setting pace and direction), and thriving (achievement of objectives and goals).  

  1. Demons – Placing a name on the flashbacks
  2. “I kept thinking of the scenes in the movie that reminded me of my life. I kept reflecting on the rape, pregnancy, demons following her.” 
  3. “I kept thinking about the depression, the changes after the rapes and the demons that followed her for most of her life.”

Outcome – Bobbi was able to firmly designate, naming the flashbacks as demons.  In accepting Aretha Franklin’s story, she is understanding that the demons are lifelong.  Accepting this makes it more possible for Bobbi to develop the “want” i.e., empowerment to balancing the demons and in doing so bring calmness into her life.

One week following the clinical intervention, I received the following email from Bobbi:

“Hello Dr. Kane,

I don’t know [what] you thought of the movie.  I believe it is making a difference.  I appreciate you taking the time, doing the planning, time, support, caring, thoughtfulness, money, and extra sessions.  I am feeling lighter, and the demons aren’t beating me down as much.  I know I will win this battle with your support.

Thank you,

Bobbi”

“In walking the landscape known as life, the terrain can be rough and unforgiving.  We focus on the journey and not the destination.  It is what we observed, experience and embrace along the way.”

–        Dr. Micheal Kane

Concluding Words – Dr. Kane

In Search of … self.

The space you are looking for

Escape

Is within

Self

You can run,

And yet

You cannot hide

From Self

Explore. Allow me to …

Find you.

– Dr. Micheal Kane

At the beginning of the analysis, I said that in the conclusion I would state the motives for accompanying Bobbi to viewing the film “Respect” and utilizing the film as a form of clinical intervention.  Ironically, this interaction began at the start of National Suicide Week. It was a concern that despite 10 years of vigilant work by Bobbi, she was soon to be lost to suicide and thus disappear. I took a bold gamble, created protocols and processes to protect my patient and stepped out of the private therapeutic environment. 

Would I do this again or recommend such actions to another colleague?  I would say no. This approach worked because of the ongoing, ten-year therapeutic relationship developed with Bobbi. For novice or newly minted therapist-client relationships there is too much risk of patient safety, possible malpractice claims and possible occurrences outside the control of the therapist to be used as a consistent treatment method.  I would recommend this action as a clinical intervention understanding the specific circumstances and needs of the individual only if conducted within the confines of the therapeutic environment.

I also want to address concerns both professionally and personally about the film.  I felt the film gave an accurate portrayal of sexual assault, domestic violence, and male/female relationships within the African American community.  I believe that my patient was able to see within the film examples of the shame, blaming and psychological impacts evident in her own suffering.  Furthermore, she was able to see the secrecy held in the family, church and community regarding the sexual abuse, pregnancy, childbirth and rearing of Aretha Franklin and her children. 

The film, as stated by Bobbi’s journal entry, portrayed Ree-Ree’s (Aretha) father and her first husband in the following context “Aretha’s father controlled her life. What she sang. How she dressed and her behavior.  Her husband #1 did the same thing. She selected the first husband like her father.  She eventually found the strength to speak up and stand up for herself.  To love herself.”

I am reminded by words within Bobbi’s journal entry when she states, “One of the things I told Dr. Kane was I had never heard of loving yourself until I started therapy.”  This is the essence of the psychological wound reinforced by repeated trauma within the family, church and community portrayed in the film and mirrored in the actual family, church and community in which Bobbi lives.  The psychological wounds of the family, church and community hides its secrets to protect its image and to do so is willing to sacrifice its children.

I reflect on the words of Ree-Ree’s friend and pianist who told her “There are no demons … it is the pain you have been running from your whole life.” I believe that he was partially incorrect.  There are demons. For example, Bobbi’s father was a senior deacon in his church.  He was hiding in open sight.  Both the Pastor and the board of Deacons had knowledge of the sexual assaults and yet took no action. The demons are the pain, and it is the pain, that the family, church, and community seek to hide to protect its image and, in the process, keep running from their responsibilities to the members of the community.

The film portrayed the lead male characters, Aretha’s father and first husband as violent, controlling, manipulative and emotionally as well as psychologically abusive.  The lead and co-lead female characters Aretha, her sisters, grandmother, and father’s girlfriend are portrayed as struggling to survive and banding together gaining strength and independence from these men. Some may suggest that the community is “broken” and that would not be true. As portrayed in film, following the death of Marin Luther King Jr, people are waiting for a leader (male) to appear. The community, rather than be broken, is psychological wounded.  The repair and healing of the wound can begin by teaching and reinforcing techniques of “loving the self” and “loving me more”. 

Until then, as a father, I fear the future of our children epically our daughters. Currently in Texas, men have passed laws seeking to control women’s bodies and access to healthcare. One woman, Denise Pitcher, Executive Director of Caribbean Centre for Human Rights, recently wrote “Men should not be making laws about women’s bodies.”

The film “Respect” affirms my response. “As long as men seek to hold the reins of power and privileged, women will never be free of their desperate grasping for control.”  Insecure men need, seek, and fight for power through which they manipulate.  Secure men let go of the want for power, seeking to empower the psychological self.  In doing so, share resources in a way that benefits all.”

African American men, have work to do.

Therapy… anyone?

The Undiscovered Territory

The past is what it was.

The present is what it is.

In the future lies what is to be uncovered.

It is the undiscovered territory

Waiting for you.

Experience the Journey of Self Discovery.

-Dr. Micheal Kane

*****************************************************************************************************************************

Family Secrets

The road to hell begins with this statement…

“What happens in this family stays in this family.”

Solution: Cut a new path

Take care of self.

As much as I love you…

I love me more.

More.

– Dr. Micheal Kane

*****************************************************************************************************************************

Welcome My Brothers the Consumer

Welcome!

We welcome you among us.

Stay as long as you would like.

We have a revolving door policy.

The lights stay on 24 hours a day.

The only darkness in the cells are the inmates.

And the beat goes on.

Welcome,

And be consumed.

– Dr. Micheal Kane

Until the next time … Bobbi’s saga continues ….

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