Online Conference Transcript

Pamela Brewer, Ph.D., has 15 years of experience working with people who are emotionally distressed or having marriage problems. Dr. Brewer says that there are times when the toxicity of our relationships with others is driven by a toxic relationship with yourself. As with many toxic substances, there are signs that may suggest you may need internal healing.

David Roberts: HealthyPlace.com moderator.

The people in blue are audience members.

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David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com.

Our topic tonight is "Toxic Relationships: How To Handle Them." 

Understanding that everyone in the audience might have a different level of knowledge, here's a link to give you the basic information about toxic relationships.

Our guest tonight, Pamela Brewer, Ph.D., has fifteen years of experience working with people who are feeling emotionally distressed or having marriage problems. She is based in Bethesda, Maryland, just outside of Washington, D.C. She also hosts a radio talk program.

Good evening, Dr. Brewer and welcome to HealthyPlace.com. We appreciate you being our guest tonight. So we're all on the same page, can you please define what a "toxic relationship" is?

Dr. Brewer: A toxic relationship is one in which you are feeling harmed either emotionally or physically.

David: What is it that causes us to get involved in toxic relationships?

Dr. Brewer: There are many reasons why we choose toxic relationships. We may have grown up in a toxic household, we may have been taught that we are not deserving of happiness, or we may have learned to take responsibility for others. One of the most important things to remember about being in a toxic relationship, is that you do have choices and you can get out!

David: Can you give us some examples of a toxic relationship?

Dr. Brewer: Wow! That's a big question! But here it goes.

A toxic relationship is one in which you are chronically tired, angry, or frightened. A relationship in which you worry about a safe time to talk to your partner. A relationship in which you do not have the "right" to express yourself. In short, a relationship that is abusive in any way may be a toxic relationship.

David: Many get involved in these types of relationships and find it difficult to break away. What is it inside ourselves that keeps us from being able to do that?

Dr. Brewer: Often, we stay in relationships because we do not understand that we have rights and options. Low self-esteem can be a factor in remaining, as well as depression, fear of being alone, or threats from the hurtful partner. Sometimes, people stay because the toxic relationship so much mirrors their lives as children, that they truly may not have a sense that it is a toxic relationship and that life can be better.

David: What is it that makes a toxic person tick? What motivates that person to hurt others?

Dr. Brewer: Low self-esteem. Although low self-esteem can be a very complex experience, the bottom line is that the person does not have a good and clear sense of themselves, and so it is almost impossible, without clinical intervention, for that person to understand that there is a better, healthier way to be.

Part of why the toxic person hurts, in addition to having to do with their own low sense of self, is that fear of being out of control and the fear of what exposing the true self would mean.

David: We have a lot of audience questions, Dr. Brewer. Let's get to some of them and then we'll continue with our conversation.

Dr. Brewer: Great!

michaelangelo37: Dr. Brewer, can you address the special issues when the toxic people are your parents who feel they deserve rights to your children.

Dr. Brewer: Tell me more about how they behave in a way that lets you know that they believe your children are theirs.

michaelangelo37: They express their displeasure to everyone about how they never see them, yet treat them badly when they do.

Dr. Brewer: How do they treat them badly? What do they do to the children?

michaelangelo37: They blame them for "acting like children," not allowing them to act age appropriate, and they over-discipline them.

Dr. Brewer: It's often very hard to set limits on parents, but the effects of not setting limits can be equally as difficult. How old are the children?

michaelangelo37: Seven and thirteen.

Dr. Brewer: How do they discipline them and have you told your parents that their behavior is objectionable to you?

michaelangelo37: Yes! I have expressed this to them many times and have limited their interaction with them. My mother has hit the youngest for wanting a snack and forced him to eat her mashed potatoes.

Dr. Brewer: How did she force him? What did she do?

michaelangelo37 At the time, my oldest reported that she forced the spoon of potatoes into his mouth.

Dr. Brewer: Were your parents abusive towards you as a child?

michaelangelo37: Yes! Most definitely.

Dr. Brewer: What you are describing is abusive behavior. It must be very painful to know that your parents are harming your children. So, are your parents doing to your children what they did to you?

michaelangelo37: Yes, it is very painful and I will not let the generational pattern continue. However, my parents now feel abandoned by me.

Dr. Brewer: Have you considered working with a clinical professional? This is such a painful and difficult experience. It sounds like you know that you have to protect your children from your parents, which means your children come first. You should feel very proud of yourself that you have been able to identify the abuse and are working to protect your children from the abuse.

Michaelangelo37, please do what you can to help yourself as you and your family work to stop the abuse and good luck to you.

SierraDawn: How about a relationship where one partner is giving what she feels is suggestions, and the other partner is seeing it as "criticism"?

Dr. Brewer: It may depend on how the "suggestions" are being offered. If they are being offered as suggestions and the other has the option to agree or disagree, then the issue may be with the person who is perceiving criticism. Which partner are you?

SierraDawn:I am the one that gives the suggestions.

Dr. Brewer: What might be useful, is communications skills counseling for both of you. You can start with some self-help books, but working with a counselor really might be the most useful thing for you both! Good luck.

David: And this pattern of behavior happens in many different types of relationships. Sometimes the "suggester" is really trying to control the other person by telling them "this is the right, the only way, (whatever it is) can be done." Am I right about that, Dr. Brewer?

Dr. Brewer: Yes, you are right. That's why communications skills training can be so useful. In part, such work really helps both to learn to speak for themselves; expressing their own thoughts and needs versus telling or interpreting for their partner.

babygirl62: Religion plays a big part in why I stay in my toxic marriage. Even our pastor told us it was toxic before we ever got married. How can I get to the point of "not going against God" and filing for divorce before it is too late for me and my kids? I am scared to "violate" the commandments. He has not committed any "thou shall not's," that would be o.k. to get a divorce. I cannot bring myself to go against what the Bible says.

Dr. Brewer: In a situation like yours, it might be useful to go outside of your church, but to still work with a counselor who has a stated understanding of your particular religious views. What makes your relationship a toxic one for you?

babygirl62: I have been in counseling, both Christian and secular, and all say to get out! However, I don't. He has been verbally and physically abusive, mostly to me but also to my kids.

Dr. Brewer: You are clearly in a difficult place. Consider that staying in a relationship in which you and your children are being harmed, may not be what was intended for you and your children. Does your partner agree with you that the relationship is toxic?

babygirl62: I love him, but also hate him at the same time. I raised one daughter by myself and don't want to see our son go through what she went through without her father being around. I understand and I agree, but I can't seem to "go against" God. And yes, he agrees.

Dr. Brewer: Some of what you will need to consider, I believe, is the harm and the "aloneness" that can come from being in an abusive household, both for you and your children. If your partner agrees that the relationship is in trouble, perhaps you both can go into a counseling environment, in which, you are jointly and actively engaged in making a change. Please consider all the ramifications in subjecting you and your children to the pain you currently endure.

Let me say to everyone, that the most difficult and most essential part of "dealing with" a toxic relationship is recognizing it and understanding that you do not deserve to be in a relationship that hurts, and that you have options. No one deserves to be harmed in any way. Furthermore, when there is abuse in a relationship, it doesn't just go away without a lot of very hard work.

David: Dr. Brewer, in each of these instances, it seems the questioner has difficulty standing up for him/herself. Do you have any suggestions for dealing with that?

Dr. Brewer: Reaching out for help can be an important part. Therapy can help, a support group (most are free) can help. Once you are in a toxic relationship, you are "taught" by your partner that it's really all your fault. If you buy into that philosophy, it can be very difficult to walk away from or set limits. However, limits must be set in order to live.

David: Here are a few audience comments on what has been said so far tonight.

babygirl62: We have separated several times. He then comes back saying he will change, and he doesn't. However, I can't lay all the blame on him because I like to control things also.

Ginger1: My husband has to have his own way. I have to ask permission to hang a picture.

Dr. Brewer: Don't kid yourself, because if your husband is such a controlling person that you need to ask permission to hang a picture, you are not the one in control. You describe the typical cycle of violence:

• a blow-up
• then the honeymoon period in which the abuser is contrite
• and then the abuse begins to escalate
• and then the explosion
• and then the honeymoon period

CalypsoSun: I grew up in a dysfunctional and abusive home, then had two abusive marriages. I had to totally disconnect with my siblings to regain healthiness. I am in a healthy relationship now but miss my siblings. I fear reconnection because of the toxicity. Any comments?

Dr. Brewer: If you have done work on yourself, and it sounds like you have, you may be stronger and in a better position to tolerate interaction with your siblings. However, remember that you have choices, and if they have not done work for themselves, you must limit your interaction with them. This is for your own emotional well-being and that is a very good thing to do!

cap1010: What if your relationship is not meant to be harmful, but you are just really bad at talking to people. Is that a toxic relationship? Can my toxic relationship just be me not being able to communicate with "friends"?

Dr. Brewer: Cap, I need an example of what you mean.

cap1010: Sometimes I feel I just cannot get my feelings out to people, or they just misconstrue what I say.

Dr. Brewer: Setting limits means that you too, have to pay attention to the limits you set. Cap, it sounds like working in a therapy group or support group, might be helpful for you to get some practice and learning how to say what you mean to. I can sense your sadness and frustration and you owe it to yourself to practice hearing your own voice.

David: For those in the audience, I'm interested in knowing what is it about you that got you involved in a toxic relationship?

Journeywoman_2000: I simply saw something better and thought it was healthy.

vioyoung: I came from a very dysfunctional family, with an alcoholic and emotionally abusive step-dad and a mom with serious emotional problems. They always made me feel unimportant, so that carried over.

michaelangelo37: The difficulty in my situation is that my parents do not respect the limits my wife and I have set. I was raised by toxic parents and had many unhealthy relationships, but I now have a healthy marriage.

Ginger1: My husband was charming before we were married.

David: Referring back to what causes someone to get into a toxic relationship, here's another question, Dr. Brewer:

vger2400: How are depression and self-esteem factors in toxic relationships? Does that mean that the person does not have a clear sense of their own boundaries and a fear of being out of control of their lives, or out of control of other people?

Dr. Brewer: When you are feeling depressed, it is hard to have clarity about your life and what is reasonable, appropriate, or respectful. Depression saps emotional and physical strength, both of which are critical in relationships. Low self-esteem tells one that they do not have rights or options, which is again, an energy drainer. And yes, depression can inhibit your sense of your own boundaries and your need and right to set boundaries with others.

vioyoung: I'm getting out of a toxic relationship (he has Narcissistic Personality Disorder), but I find myself feeling sorry for him because now he's being so nice. I know he's just trying to woo me back and nothing has changed. So, do you have any tips on how to not feel sorry for him?

Dr. Brewer: It's okay to feel sorry for him, as long as you don't feel responsible for him. You also have to remember that you have the right to a happy life!

vioyoung: Thanks, I keep telling myself that!

Dr. Brewer: As you should! :-)

David: That seemed to have hit a chord with some others in the audience:

babygirl62: Ouch! You hit the nail on the head when you mentioned feeling responsible for him. That is how I feel....:(

joe rose: Eric Fromm said that in order to be related to another person in a healthy productive way, one must first be properly related to oneself. Assuming you agree with that statement, how would you describe being properly related to oneself?

Dr. Brewer: The good news about recognizing that you are not responsible for your partner is that it frees you up for being responsible for yourself, and remember, as long as you accept responsibility for your partner, you are telling you and your partner that they don't have to change. Furthermore, that they are not responsible, that instead, you are! Now, that is not the message you want to give!

I wrote a book, Relationships In Progress, about just that idea! The way you begin to relate to yourself is to work at knowing yourself and then paying attention to the things you know, which means, not allowing your core values to fall by the wayside in a relationship.

kaybecca: What about in a marriage, when one partner tries to make the other feel worthless all the time?

Dr. Brewer: Kayrebecca, that really sounds like emotional abuse, don't you think? Emotional abuse is just as toxic as physical and sexual abuse and not okay!

tonny: Could you recommend a book about communication skills training?

Dr. Brewer: Yes, there is a wonderful book titled "Couple Skills" published by New Harbinger.

David: One thing I was thinking about, since we are a mental health site, many of the people who visit here have various psychological disorders ranging from anxiety disorder to bipolar disorder to DID and because of that, and the stigma it carries, they find it difficult to break away from any sort of relationship because they are afraid, and sometimes "anything is better than nothing."

Dr. Brewer: It is important to remember that when "anything is better than nothing," the "anything" is nothing. And a very hurtful nothing, at that, regardless of one's mental health diagnosis, the right to be in a loving and respectful relationship exists. No one should have to endure the pain of a toxic relationship. That being said, it is also important not to blame oneself for having a difficult time of breaking free, if breaking free is the only option. Toxic relationships are often the most difficult to leave.

David: As you were writing your answer, I was thinking to myself that it's important to remember that "breaking free" and the loneliness that occurs is temporary. And it's important to remember that "This too, shall pass."

Dr. Brewer: Absolutely! And what you are freeing yourself for, is a relationship that does not hurt.

David: Dr. Brewer's website can be found here.

slg40: Do you think we are afraid of the pain-free relationship and it might keep us trapped longer in a toxic one?

Dr. Brewer: People do often fear that with which they have no familiarity. What often keeps people in toxic relationships, in addition to the things we've already discussed, is sometimes the belief/fear that "this is all there is." That isn't true, but often that is the fear.

joe rose: Would you say that when one abandons his core values for the sake of maintaining a relationship, or placating one's partner, that this is the beginning of an unhealthy dependency on that partner for the sake of whom one has in a sense betrayed himself?

Dr. Brewer: Yes, self-betrayal is exactly what is going on when we allow ourselves to lose sight of our core values, and of course, we live in a world in which we are frequently encouraged to walk away from our internal value systems.

David: There were lots of people in the audience tonight, Dr. Brewer, who agreed wholeheartedly with what you had to say. Your comments and those of other audience members really struck home. Here are a few of their comments:

CalypsoSun: "This too shall pass!" Yes, sir! And it really does! Thank you, for that comment ;-) You said a MOUTHFUL there, Dr. Brewer! Thanks!

babygirl62: I agree with you, Dr. Brewer, about the emotional abuse being just as toxic as other abuses.

vger2400: They try to make all your decisions and second guess you on everything. We feel guilty when we do something nice for ourselves because we are so used to taking care of everybody else. I guess that is codependency.

punklil: So true!

Dr. Brewer: Ha-ha! Thank you, David, for sharing the comments.

David: Thank you, Dr. Brewer, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. I hope you'll visit our main site too. there's a lot of information there: http://www.healthyplace.com Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others.

Thanks again, Dr. Brewer. Good night everyone.

Dr. Brewer: David, thank you! Good night!

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

Have you ever been stalked or been afraid that someone is stalking you? It's a terrifying experience.

Psychiatrist and stalking expert, Dr. Doreen Orion, on obsessive love and stalkers. Learn what to do if you become a victim of stalking and how to tell if a stalker will become violent.

Dr. Doreen Orion: Guest speaker.

David: HealthyPlace.com moderator.

The people in blue are audience members.

BEGINNING OF CHAT TRANSCRIPT

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Tonight, our topic is on "Stalking and Obsessive Love". We have a wonderful guest: Psychiatrist and stalking expert, Dr. Doreen Orion author of the book: "I Know You Really Love Me: A Psychiatrist's Journal of Erotomania, Stalking and Obsessive Love".

We'll be talking about why stalkers do what they do, the different types of stalkers and their impacts on victims. Also, learn what to do if you become a victim of a stalker.

Good Evening, Dr. Orion and welcome to HealthyPlace.com. Thank you for agreeing to be our guest. You were a victim of a stalker yourself. Can you share the details of that with us?

Dr. Orion: I've been stalked for over ten years by a former patient I treated for 2 weeks.

David: What happened?

Dr. Orion: This person has erotomania - the delusional belief that another is in love with you. She has followed me home, peeked in our window, sent numerous notes and letters. She even moved to Colorado from Arizona, following my husband and me.

David: That must be very frightening. How are you dealing with that, emotionally?

Dr. Orion: It's a process. At first, I was definitely in denial that it was happening. Then I became angry as well as afraid. My emotions vary depending on what's going on with the stalker, where she is, etc. I'm very fortunate that I have a wonderful support system.

David: Why is it that you couldn't simply have this person arrested and taken away?

Dr. Orion: I wish it were as simple as that, and that is a large part of why I wrote my book; to help educate law enforcement as well as victims. In many states, even today, unless a stalker makes a direct threat, the police do not arrest.

David: Dr. Orion, I'm assuming there are different reasons why people stalk. Can you elaborate on that and also on the types of people, personality-wise, who do this type of thing?

Dr. Orion: In the case of the person stalking me, she is delusional, psychotic. Those types are often the most difficult to stop because they simply do not understand that the victim truly wants no contact.

David: What about the other types?

Dr. Orion: The more common type of stalker is one who has been in a relationship with the victim and can't let go. These people are extremely narcissistic - they want what they want and they do not care if the victim does not want the same.

David: I was sharing my personal story with someone in the lobby earlier tonight. I dated a woman about 6 years ago. I ended the relationship. First, the phone calls came at all hours with the hang-ups. Then, it escalated to the point when I walked outside my house one morning, my windshield was hammered in. I called the police and nothing could be done. Then one night, I came home and she had broken a window in the rear of my house and was inside sitting in the living room waiting for me. I share that story because when I announced the conference I heard from several people who shared their relationship "stalking" story with me.

Here are a couple of audience questions:

xtatic: Are there things you can do to get out of a relationship; where you think the person will become obsessive? Is there anything you can do to to make the situation lessen?

Dr. Orion: You have to be firm and clear. Don't try to be overly "nice." You shouldn't be obnoxious, but being too nice can send the wrong message. Women, particularly, often want to "let the guy down easy." They are concerned about his feelings. So when he starts making the obsessive calls or turning up at her work, she's "nice" and tries to reason with him. That's just giving him what he wants; contact. I also wanted to respond to what you said earlier: Every time I speak at professional conferences on stalking, so many people tell me their stories. So, what you experienced in people sharing their's is very common. About 8% of U.S. women will be stalked some time in their lives.

David: You were stalked by a woman, as was I. Is it unusual that women are the stalkers?

Dr. Orion: Yes. It seems to be that an overwhelming majority of stalkers are male (in the 80%s). However, I also believe that women stalking men are underreported.

DawnA: Is there a profile of a stalker?

Dr. Orion: There is no one stalker profile and one of the big problems in researching the stalking literature is that no 2 research centers can agree on what to call different types of stalkers. The only exception is erotomania, which I've described above, since that is the only psychiatric diagnosis routinely associated with stalking.

David: Can a person only find out that another person, maybe the person they are dating, is a potential stalker when the "breakup" comes, or are there some early warning signs?

Dr. Orion: I'll use the pronoun "he," since male stalkers are more prevalent: A man who will later stalk a woman, has been in a relationship which is frequently controlling, while the relationship is going on. i.e., he might tell her what to wear or that she can't see her female friends. It is also not unusual for stalking behavior to begin before the relationship ends, i.e. he might show up at her place of work to make sure she's really there or listen in on her phone calls.

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David: Here's another audience question:

iscu: Would you say most stalkers are dangerous in a violent sense?

Dr. Orion: A significant number are. It's important to look at several factors when assessing if a stalker might become violent:

Drug/alcohol use increases potential for violence, so does a past history of violence. It also seems that if a stalker who had a prior relationship with the victim threatens the victim, that can increase violence potential. BUT there are many cases in which stalkers never threatened and still became violent.

It is also very important to understand that there are situational factors that can increase violence in stalkers: e.g. anytime the stalker is angry at the victim or feels humiliated by her. Unfortunately, those times often occur when the legal system is involved, i.e. when a restraining order is served.

TexGal: How can one find out who the stalkers are when supposedly no one witnesses, police won't get involved, fingerprints supposedly are not on file. I was stalked from 1990 to 1996. I moved and was stalked there too. So all together, 7 plus years of being stalked.

Dr. Orion: There are cases like that and they are very difficult. There was a case I wrote about in my book where a mother found out the identity and whereabouts of the man (a convicted felon) stalking her daughter, even when the police had no idea who he was. She was extremely resourceful and persevered, so it can be done in some cases.

David: Is it, in most cases though, that the victim doesn't become empowered, but rather frightened and withdrawn?

Dr. Orion: In many cases, yes. I met a woman once who ended up a virtual prisoner in her trailer, never leaving, and keeping sheets over her windows. She lived like that for some time. I do sincerely believe, though, that as more is learned about how dangerous stalking behavior is, and how disruptive it is to a victim's life (even if there has been no physical violence) that the laws will improve and will help empower victims.

jill: I'm a female and it has been a little over a year since I've been stalked. Now I'm starting over again and have begun dating, but sometimes I worry that I might end up in the same situation again. What should I do to overcome my fears?

Dr. Orion: Fabulous question and a very common problem for stalking victims. The best advice I can give you is: trust your gut. Gavin de Becker's book, Gift of Fear is excellent for helping with that. If I were you, I would also take a long, honest look at that last relationship and ask myself, "What did I miss?" "What signals did I ignore?", not to blame yourself, but to learn and give yourself some valuable tools.

David: I'd like to ask members of the audience: if you've been a victim, how did you handle it emotionally?

TexGal: I journaled extensively but I developed a seizure disorder due to a different trauma and the stalking only exacerbated the seizures

cheyenne4444: Emotionally, very badly. I became very withdrawn, was frightened for my life, and would walk with my head down so I could not look at others, which would upset him. Also, I was unable to see my friends, and he always watched me or had someone watching me, down to the detail of what I was wearing. So I pretty much gave up and withdrew, letting him make all decisions for me. My ex's mother was bipolar, and I believe he was too.

Dr. Orion: About the stalker making all the decisions, this goes back to what I was saying before: that they are often controlling while the relationship is going on. It starts with little things and just escalates.

jill: I told my stalker's parents about their son being a stalker.

Dr. Orion: For Jill - what happened when you told his parents? My stalker's parents knew and they only helped her have more access to me because they were afraid of her themselves!

jill: They actually tried to get help for him. It seems like he felt ashamed of what he was doing and it did work for a while.

marie1: Is there any evidence indicating that stalkers suffer more than the general population from bipolar disorder?

Dr. Orion: That's an interesting question about bipolar disorder. There is no solid evidence, but there do seem to be many cases in the literature of stalkers with bipolar.

David: What do you recommend if a person becomes a victim of a stalker?

Dr. Orion: The most important thing is not to have any contact with the stalker. NONE. Even negative attention is worse than no attention at all. If he calls you 30 times and you let your machine pick up and on the 31st you can't stand it anymore and you yell into the receiver, "don't call me again" all you've done is teach him it takes 31 calls to get a rise out of you.

I also think it's important to emphasize that everyone tells victims to get restraining orders, but this is not always the best advice. If you are considering getting one, you must first research how these orders are handled in similar cases in your jurisdiction. Do the police arrest or do they just warn? The woman stalking me violated the restraining order 24 times before the police arrested her, and then did so only because the responding officer had himself been stalked. In jurisdictions in which police don't arrest for violations, it's often better not to get one, because then the stalker feels emboldened - like he can do anything, even more than he's doing already and the police won't arrest him. Find out, if you can, what the stalker's response has been in the past to restraining orders (if they've been issued). If he has stopped in the past, that's good. And, again, be aware that getting a restraining order can put you in more danger.

David: What you were saying a moment ago, regarding the calls example, sounds very much like "parenting advice;" what a therapist might say to a parent who has a child who acts out a lot.

Dr. Orion: Good analogy. I often say that a stalker acts like a child. He'd rather have your love, but he'll take your anger if there's no alternative. The worst thing is to be ignored. But often, that's the best tactic and hope that he will get bored and go away.

---

David: Here's a good question:

TexGal: Can a stalker be reformed?

Dr. Orion: Such a good question, it's a shame there's no good answer. Studying stalkers, including treating them, is so new that there are no known absolute treatments. Obviously, if a stalker has an underlying mental illness (and about 50% seem to) it's very important to treat that. It also seems that court-ordered treatment, particularly close supervision, works better in many cases than voluntary treatment, because stalkers often don't feel they have a problem.

mjonesy: I've been stalked now for over 6 years. I haven't responded to him in any way for at least a year, but he still comes over to my home. I have heard mixed opinions about using restraining orders. Women seem to think it just incites the stalker to bother you even more. A policeman in my area says he can't help me until I file a restraining order. But my stalker is different than others, I think because he comes over to my home and enters my home to do damage.

Dr. Orion: It's difficult to understand how the police say they can't do anything if there is evidence of breaking and entering into your home. Again, the opinions and even the data on restraining orders are mixed. In my own case, I did not respond to the stalker in any way for 3 years, but it kept getting worse, then I got a restraining order which I wish I hadn't when I found out the police would not arrest.

mjonesy: He does his damage to my house when I'm not there. He gets a big kick in the fact that he can come into my house without breaking any windows or doors.

David: A few more audience comments on what has been said so far:

DawnA: In our California county, we have mandatory 52-week Batterers Treatment Counseling for domestic violence offenders. The treatment provider runs a Stalker group within the program. I know a Prosecutor who was a stalking victim. The stalker continued to "stalk" from jail with letters.

TexGal: I helped a lady who was being stalked, even drew a sketch of her stalker, she saw him, she was bi-polar and it caused serious problems with her health.

Dr. Orion: I know of cases like TexGal's where police will set up surveillance tapes to catch the perpetrator, or the victim does it herself. Other victims in this situation have gotten a dog.

cheyenne4444: What is the worst judicial punishment a stalker can receive?

Dr. Orion: In terms of punishment: California is the most progressive state for stalking victims. They have many excellent programs like ESP in Los Angeles. In other states, stalkers can get up to 20 years for felony stalking, but the usual punishment is 3-5 years.

David: Are stalkers serial in nature. After they finish with you, do they go onto the next person?

Dr. Orion: Some stalkers are serial. One study found that in the case of erotomanic stalkers, 17% stalked previous victims. There is also evidence that in that kind of stalking, having had more than one victim increases the propensity for violence.

David: It's getting late. I appreciate you coming tonight Dr. Orion and being our guest. And I want to thank everyone in the audience for coming and participating. I hope you found the information helpful.

Dr. Orion: Thank you.

David: Here's the link to Dr. Orion's book: I Know You Really Love me.

Good night everyone.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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Richard Gartner, Ph.D., joined us to discuss male sexual abuse and the stigma surrounding it. He talked about how men react to their abuse by displaying hyper-masculine behaviors, behaving in stereotypically masculine ways. Dr. Gartner noted that many sexually abused men, left untreated, develop depression, flashbacks, and compulsive behavior (for instance, becoming a sexually compulsive) to cope with being traumatized by the sexual abuse experience.

Audience members had questions about whether unwanted sexual contact with a man could turn a boy gay or affect one's sexual orientation. Others spoke about how being betrayed in an important relationship has now affected their ability to have intimate relationships.

Other topics included: being too ashamed to talk to anyone about what happened, the cycle of victimization, the fear of becoming an abuser (do boys who were abused become men who are abusive?), and where to get help.

David Roberts: HealthyPlace.com moderator.

The people in blue are audience members.

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Sexually Abused Men." Our guest is Richard Gartner, Ph.D, Director of the Sexual Abuse Program at the William Alanson White Institute in New York City. He's also on the board of directors of the National Organization on Male Sexual Victimization. In addition, Dr. Gartner is the author of Betrayed as Boys: Psychodynamic Treatment of Sexually Abused Men. He is also the editor of the book Memories of Sexual Betrayal: Truth, Fantasy, Repression, and Dissociation.

Beginning of Chat Transcript

Good evening, Dr. Gartner and welcome to HealthyPlace.com. We appreciate you being our guest tonight. So we all start off on the same page, can you please define "sexual abuse" for us?

Dr. Gartner: Good evening, David and everyone. First of all, abuse is the use of power to get one person to fulfill another person's needs without any regard to the needs of the person who is the subject of the abuse.

Sexual abuse, uses sexual behavior to fulfill that.

David: One of the things I've gathered from emails I've received is that a lot of men are afraid to admit they've been abused. It seems it has a lot to do with the way they perceive themselves as men, or being afraid of how others will perceive their manhood.

Dr. Gartner: That's very common. Unfortunately, in our society, victim-hood is seen as the province of women and for men to acknowledge that they've been victimized to them is saying they aren't really "men." And this is a very unfortunate part of masculine socialization -- how we learn to be men. They feel shamed by the idea that others will think they are not male, just because they've been abused.

David: And so is there a different way that men perceive their abuse vs. the way women perceive it.

Dr. Gartner: Well, often men see early, premature sexual behavior as a sexual initiation. Often they convince themselves that they initiated the sexual situation with the adult. This is one way of feeling that they were in charge in an exploitative situation.

David: Does sexual abuse affect men differently than women?

Dr. Gartner: Up to a point, yes. There are many aftereffects that both men and women often show, like flashbacks, depression, or compulsive behavior of one sort or another. Men, however, have been socialized to believe that men do not have "weak" feelings so they do not let themselves be vulnerable if they can help it. I am speaking in generalities here, of course.

Often to avoid the sense of being powerless, they become what we call hyper-masculine, behaving in stereotypically masculine ways, but these hyper-masculine behaviors make it very difficult to process what was a very painful exploitation.

David: One of the things I read is that men aren't as traumatized, or don't feel as traumatized, by the sexual abuse experience. Is that true? And is that a result of the compensatory behavior -- acting more like a "man"?

Dr. Gartner: It depends how you measure the trauma. Men are likely to say that they were not traumatized by the abusive behavior, especially young men in their late teens to mid-20s. However, men with histories of unwanted childhood sexual behavior with adults are much more likely to come to psychotherapy than men without those histories, but for reasons that SEEM unrelated to the abuse.

David: How are intimate relationships affected?

Dr. Gartner: Dramatically. If a child is betrayed in an important relationship, especially with a loved and trusted caretaker, as is often the case, then the trauma is not just about the sexual acts but about the break in the trusting relationship. This makes it harder to enter trusting intimate relationships later in life.

A man may have some kind of sexual dysfunction which, of course, affects his intimate relationships. He may be sexually compulsive, or feel numb during sex, especially if he feels, even for a moment, that he is not in charge of what is happening, so he may not allow himself to truly BE intimate with another person.

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David: Now, this may sound silly, but a lot of sexually abused men are concerned about this. Will male childhood sexual abuse affect your sexuality? Will it make you gay?

Dr. Gartner: It does not sound silly. It is an important question; it relates to a fear that makes many boys and men not talk about their abuse. Conventional wisdom is that early sexual contact with a man can "turn" a boy gay, but most clinicians believe that sexual orientation is well formed by the age of 5 or 6 and for boys, the average age of their first abuse is about 9. In addition, gay men with sexual abuse histories report that they usually had a sense that they were gay BEFORE the abuse occurred. The problem is that boys growing up to be gay, in almost all cases as they try to understand their sexuality, ask themselves "Why am I this way?" It's very easy to say, "Oh! it was the abuse." Paradoxically, though, gay men who were abused by women often ALSO blame their orientation on the abuse.

David: Also, many times when we think of abuse, for whatever reasons, we think of men as the perpetrators of the abuse. Is that also the case with sexually abused boys?

Dr. Gartner: Are you asking about female abusers?

David: Yes, I am.

Dr. Gartner: There are far more female abusers than most people believe. In a study at the University of Massachusetts at Boston they found that, of the men who acknowledged a history of abuse, about 40% said they had had a female abuser (this includes men who were abused by both men and women). But women often abuse in ways that are not as obvious -- it may happen, for example, in the guise of cleanliness -- over-attention to cleaning a boy's genitals in the bath.

David: I have some other questions, but let's get to a couple of audience questions first:

mark45: What about being abused by both parents?

Dr. Gartner: This does indeed sometimes happen, unfortunately. I have known of cases where both parents included the boy in some sexual act together. Is there a particular question about such a situation that you want to ask?

David: I would imagine, especially after an experience like that, it would be hard to trust anyone again?

Dr. Gartner: That is true -- yet many men have enormous resources within and can overcome even such a total betrayal.

Terry22: I was sexually abused by several of my mom's boyfriends when I was in grade school. I have a very hard time with intimacy. I can't just simply show my love. Have you known anyone to overcome this fear of giving and receiving love due to sexual abuse?

Dr. Gartner: Yes, definitely -- it requires a lot of patience and often a relationship with a therapist is helpful here. Having someone to talk to about the distrust, and someone to, perhaps, learn to trust. Of course, some partners are also very patient and can be very helpful if they do not take the reluctance to show love as a personal attack.

David: Given the fact that many men don't seek therapy for anything, much less abuse, I'm wondering if these issues can be dealt with on their own -- sort of through self-help?

Dr. Gartner: Yes, of course. There are, for example, a number of books that can be helpful here -- a small number, but it is growing. Victims No Longer by Mike Lew, Abused Boys by Mic Hunter, and my own Betrayed as Boys (which is written for professionals but I believe is accessible to many men). The reluctance to enter therapy is really part of the problem I was talking about -- men aren't supposed to have needs. So I would hope that men would reconsider their concerns about being in therapy.

TFlynn: Betrayal !! I believe it is a hell of a lot more than that. How does a child of 8 work that out in his head? Who does he turn to? Are you not brought up to respect and honor your mother and father?

Dr. Gartner: That is exactly right -- that is why the betrayal is so huge. If a boy is lucky, there is someone in his life to whom he can turn -- a teacher, or grandparent, for example. It is very difficult to allow yourself to let in what was done to you, if it was done by a parent. Especially because, in some cases, that parent is beloved and helpful and supportive in some ways. I think a child of 8 can't really work that out in his head --you are right.

David: How do you even figure that out as an adult?

Dr. Gartner: An adult does have more resources to figure it out, but it is indeed very difficult. One of the most helpful things is not to be silent.

mark45: How can a person find a place to start talking about being abused?

Dr. Gartner: You are asking about where to go for help? It depends where you are, of course. Often good hospitals have rape intervention programs, and while these were developed to help women who were raped as adults or who have a history of child abuse, the good ones know to treat men as well, and often that help is free. At least they should be able to refer you to an appropriate place. There are also centers that treat abuse and incest in some cities.

paxnfacto: SO what if that is NOT the case (that they are so lucky)... What if you have no other trusted adult to turn to?

Dr. Gartner: That is the case as a child, but it doesn't have to be the case as an adult. I have known boys who made it their business as they got older to find people in whom they could confide. Silence is one of the worst aspects of abuse. If a boy or man feels too ashamed to talk to anyone about what happened, then it festers.

I run groups for sexually abused men, and I am always amazed and gratified when they see that they are not alone and what a difference that makes to them. This is only a first step in healing, of course. There are also some web sites now that have chat rooms and bulletin boards where sexually abused men or their partners can talk to one another anonymously, as you are doing here.

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guthwyn: Dr. Gartner mentioned depression as an aftereffect. My question is: How does one know which methodology to use in the resolution of this issue? For example, through further psychotherapy or via a medical approach, in the context of chronic depression and extensive abuse histories.

Dr. Gartner: It doesn't have to be one or the other. I often see men in psychotherapy and refer them for medication consultations as an adjunct. If an antidepressant works, often the man begins to be able to behave differently in the world and then we have different, new things to talk about in the therapy.

David: Here's an excellent question:

paxnfacto: How does an adult male, who has had to struggle all his life to maintain some interpersonally developed sense of himself and his GOOD place amongst his family and society, finally come out and spill the beans, as it were, without shattering the very foundations of that sense of self and his place in both this society and his so-called family?

Dr. Gartner: It sounds like that sense of self had to come through covering up a terrible secret, so I wonder how solid it could be. Every case is different, of course, and I am not saying that every family in which abuse took place needs to dissolve. In fact, it is indeed very difficult to accuse, say a parent, of abuse and split the whole family if some believe you and some do not. I think that, in some way, the abuse has to be recognized, at least privately, for that sense of self to be solid.

TFlynn: Do you really think that he would turn to another adult for help. I think it's just the beginning of a long reign of isolation and the beginnings of self-abuse. How can you break that cycle of victimization? Don't many males go from being abused to abusing themselves through various substances like drugs or alcohol?

Dr. Gartner: Yes they do. Alcohol, drugs, gambling, overeating, overspending, and sexual compulsion are all things that men may turn to when they need to sooth the tremendous pain they feel. Often when men come to me it is because they finally realized that they were killing themselves through such self-abuse.

I'd like to speak also of the fear of becoming an abuser.

David: Please, go ahead. I think that's a common fear.

Dr. Gartner: The conventional wisdom is that boys who are abused become men who are abusive, but the overwhelming majority do not. Although it is true that most abusers were themselves abused, they are the ones who turned to that hyper-masculine way of living, in which you act out your feelings rather than reflect on them. The fear that people will think you are an abuser, or the fear that you will become one, is another reason men are reluctant to speak of their histories.

David: I'm wondering if the anger or rage that might build up from not being treated, from having to cope with all those difficult feelings internally, might lead the person to become physically or emotionally abusive?

Dr. Gartner: Well, yes, that is what I was referring to -- these are the men who are living in pressure cookers. Also, we often imitate the behaviors we grew up with, so even if we do not become physically or sexually abusive, there may be a tendency either to become exploitative oneself or to be easily exploited by others if someone is "trained" to be a victim.

I would also recommend that people look at the web site of the National Organization on Male Sexual Victimization (NOMSV).

David: Are there any other seminars or retreats that you might recommend for our audience members to attend?

Dr. Gartner: NOMSV is planning to offer retreats in the future -- we did do one in California two years ago. I would say check the web site from time to time to see whether one is scheduled. Also, Mike Lew often does a summer weekend workshop.

David: Thank you, Dr. Gartner, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have a very large and active community here at HealthyPlace.com. You will always find people in the chatrooms and interacting with various sites.

Here's the link to the HealthyPlace.com Abuse Issues Community. You can click on this link, sign up for the mail list on the side of the page so you can keep up with events like this.

Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others. http://www.healthyplace.com

Dr. Gartner: Thank you for having me, and thanks to the people who listened and asked questions.

David: Thank you, again, Dr. Gartner. Good night, everyone.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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Dr. Karen Engebretsen-Larash: Guest speaker. Even after the abuse has ended, the traumatic memories remain. This conference focuses on how to effectively deal with those traumatic memories. Dr. Engebretsen-Larash specializes in trauma-related disorders.

David:HealthyPlace.com moderator.

The people in blue are audience members.

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Beginning of Chat Transcript

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com Our topic tonight is "Coping With The Traumatic Memories of Sexual Abuse." Our guest is Dr. Karen Engebretsen-Larash, psychologist and specialist in treating trauma-related disorders.

Dr. Karen: Good evening everyone.

David: Good evening, Dr. Karen, and welcome to HealthyPlace.com. Can you define for us what traumatic memories are?

Dr. Karen: Traumatic memories are any recollections either in the mind or body that the unconscious tries to communicate with the person who has been traumatized. These memories can occur at any time, even long after the sexual abuse has taken place.

David: Why is it that long after experiencing sexual abuse, some people are left with very vivid traumatic sexual abuse memories that are difficult to deal with, much less get rid of?

Dr. Karen: The mind has a way of protecting itself from pending danger and does a pretty good job at protecting the self; but in times of great stress, it is likely for these memories of sexual abuse to increase in frequency which is a signal that the unconscious can no longer continue to suppress this information.

David: Some people say they are "haunted" by memories of traumatic experiences which intrude on and disrupt their daily lives. They often can't get the "pictures" of the trauma out of their heads. How can an individual deal with this in an effective manner?

Dr. Karen: They can, but it generally takes years to work through the aftermath of repeated sexual trauma. In the recent past, I have been working with Dr. William Tollefson who developed the WIIT (Women's Institute for Incorporation Therapy). He developed this technique to remove the "pain" aspect or the "self" figure so that patients can continue doing the uncovering work necessary for healing. Although his focus has been on the inpatient population, he has been making this available on an outpatient basis. In my clinical experience, I am amazed by how much more quickly we can speed up the therapy process following Incorporation Therapy.

David: Why do some people undergoing extreme stress have continuous memory and others have amnesia for all or part of their experience?

Dr. Karen: That's a good question. We are all born with certain coping strategies and we learn at a very early age what is safe to let others know about us and what is not. Individuals who have "continuous" memories are generally so crippled that they cannot function. Others become extremely creative and develop a system whereby they can access different "parts" (or alters) to cope with stressful situations. This is the extreme form of PTSD (post-traumatic stress disorder) and can lead to dissociative identity disorder (DID).

David: Dr. Karen, here are some audience questions:

LisaM: I would like to know if remembering parts of the trauma every few months or years is 'normal' or common?

Dr. Karen: Yes, it is common. Certain things can trigger a memory that may not have bothered you in the past.

David: If you can remember the abuse but not the feelings associated with them, only visual memories, how do you get in touch with those feelings?

Dr. Karen: That's a good question. It is likely to believe that you were told that you were not permitted to feel in any way shape or form. However, the visual memories remain and are a signal that the brain is trying to work through this unresolved conflict.

David: Can these traumatic memories also be experienced in physical ways (i.e. tremors, headaches, etc.) as well as, or instead of, psychologically?

Dr. Karen: Absolutely! In fact, if we pay attention to our bodies they will give us all kinds of clues about what's going on in our heads.

angeleyes: Why do the memories seem so unreal or dreamlike? I end up questioning their validity. If they hadn't been verified by other family members, I would not believe me.

Dr. Karen: No one wants to believe that the very person (or persons) they were supposed to trust for their care and safety would betray them. In the mind, that just doesn't make sense. So an elaborate defensive system develops to keep the individual from having to face the horrors of what is happening to them. Please understand, all memory is screened by the brain and as we recall information, it goes through different filters in the brain. It is unlikely that any memory is recalled exactly as the abuse happened, but that is not the point. What is important is that the "self" was damaged in the process and needs to be healed.

Sleepy pair: Is there anything I can do about body memories to make them stop?

Dr. Karen: I always recommend that patients have a complete physical examination to make sure that there is not something medical which needs to be addressed. Once medically cleared, I would recommend that you find a therapist who is able to work with "body memories" to help ease the physical and emotional pain which accompanies these traumatic memories.

David: Is there anything she can do on her own in the meantime?

Dr. Karen: Guided imagery is a wonderful tool. While in a relaxed state, create a safe place in your mind. Visualize the places which are hurting and imagine that a warm healing hand has arrived to heal the wound. Please remember, working through sexual abuse memories can be complicated and you need to develop a good working relationship with a therapist so that they can address the other issues which arise in the course of dealing with these traumatic memories.

dawnblue: Dr. Karen, how do we deal with the nightmares in our own day-to-day lives? I can't even find a therapist in my own area, much less one that is familiar with a new technique. What can we do ourselves to lessen some of the anguish?

Dr. Karen: Good question. Eye Movement Desensitization and Reprocessing (EMDR) is a technique that has been found to be very effective in the short-term. If you go online on the search engines and look up EMDR, I am sure you can find some local clinicians who are practicing this technique. Also, I often recommend books to my patients on a variety of subjects. Several include: "Healing the Child Within" by Charles Whitfield and "Victims No Longer" by Mike Lew. If you look in the reference book section of my website, you will find a list of other books which would be helpful for your healing process.

lpickles4mee: What do you suggest someone do if they know it happened, but do not remember anything?

Dr. Karen: I guess I would ask how you "know" it happened if you have no memory of such. Were you told it happened or do you just have a "feeling" it happened? By the way, there are a couple of other good books which may also be of interest. For example, "Memories of Sexual Betrayal: Truth Fantasy, Repression and Dissociation" by R. B. Gartner and "Trauma, Memory and Dissociation" by JD Bremner and CA Marmar.

David: Here's another memory question, Dr. Karen.

Chatty_Cathy: Dr. Karen, is it necessary to try to remember every incident of sexual abuse, or is it enough that once I acknowledge the ways in which I was hurt, I focus on the emotional aspects and work to change how I feel about myself and how I deal with things today. I am not sure I see how remembering every single incident will do anything but hold me back in the past. Thank you.

Dr. Karen: I agree totally. Wallowing in the past is futile at best. What is important is to acknowledge that the abuse occurred and move on. Once you begin to put the pieces of your life back together, you have the possibility of developing a happy, healthy, confident, competent self which can enjoy all the successes life has to offer. Let's face it, recovery is hard work and it is a LIFE LONG process, not a one-time event during the therapy process.

David: Given that everyone is different and heals at different levels and rates, do the traumatic memories of sexual abuse ever go away or is the best one can hope for a reduction in the frequency and intensity of the sexual abuse memories over time?

Dr. Karen: I don't think the objective is to rid the self of the memories. On the contrary, the memories are a gift, a signal that the brain is now ready to get to work and finally work through the trauma. There are different ways to obtain symptom reduction, through meditation, exercise, reading and other self-care tools. There are no easy answers and certainly no quick fixes. Finding a good support group can be a big help. Certainly, the internet has made it possible for individuals to reach out like never before. Find a support group you feel comfortable with and interview several therapists before making a decision about who to work with.

David, in reference to the latter part of your last question, I don't think memories ever go away, but they become less intense over time. Like I mentioned before, I have seen some dramatic results with the Incorporation Technique in working with both male and female abuse survivors.

David: I think that's comforting to know. Here are some more audience questions:

kapodi: I am currently struggling with flashbacks and nightmares. A friend who has been with me during these has said that I seem to go back to infancy in my behaviors and sounds. I remember nothing when these happen, except that they start with a feeling of slow puffball like things coming towards me and slowly speed up to the point where it is out of my control. I cannot find a way to stop the puffballs once they start. My therapist recommended Eye Movement Desensitization and Reprocessing (EMDR). The EMDR therapist could not work with me. What can I do about this?

Dr. Karen: EMDR is not a cure all and it does not work for everyone. It is meant to be a stabilization technique but not a cure. Based on how you describe your symptoms, it is likely that the dissociative process is becoming more intense over time. That is not uncommon when you start to do some really intense therapy. Kapodi, I am not familiar enough with this technique to make any recommendations, however, I will say that seeking alternative therapies can prove to be very beneficial. Remember, we are all unique individuals and there is no single cookie-cutter approach that will work for everyone.

Krittle: Dr Karen, when dealing with the specifics of the abuse and you receive a diagnosis of Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) how do you defend your diagnosis with the "church goers" and their belief that you are just possessed and need religious intervention? Thanks for your time. :-)

Dr. Karen: That's an excellent question! In fact, I am working with a DID (Dissociative Identity Disorder) patient who was told she was evil and a "bad seed" and a priest attempted to "exorcize" her. Obviously, it did not work. Incorporation Therapy accomplished what prayer alone cannot. Please understand, I am very respectful of people's belief systems regardless of religious affiliation. In fact, as part of the Incorporation, it is necessary for individuals to access their God or higher power in order to incorporate.

theotherboo: Do you feel that there is a time frame, a certain length of time, that someone should be seeing a therapist?

Dr. Karen: That's a good question too. Most psychoanalysts would say at least 4-5 years on the couch is necessary, and since I was trained along those lines and am an analyst myself, would have said the same thing. However, since we live in an age where insurance benefits are almost non-existent anymore, I have looked for more creative ways to speed up the process. Like I mentioned earlier, there are many wonderful book references on my website which provide a wealth of information. Of course, bibliotherapy has nothing to do with psychoanalysis, but it gives additional support to the process.

StarsGirl9: Is there any way to deal with flashbacks while in the middle of the day, say, if something is triggering them at work?

Dr. Karen: One of the techniques I teach my patients is to fix your eyes on a focal point, put your feet on the ground and take three deep breaths and focus on something pleasant. Another thing I require my patients to do is write a list of 50 positive affirmations and recite this list FIVE times a day in front of a mirror for 6 months. An example of a positive affirmation would be: I am creative for me, or I am intelligent for me, I am sober and focused for me, I am talented for me, I am loving to me for me, etc. It is important that NO negative statements are part of this list. The objective is to reprogram the negative abuser values with new values, which are unique and special for you. Remember, one bad apple can spoil a whole bunch and one negative comment can ruin all the 49 positive affirmations.

David: Sometimes, Dr. Karen, the intensity and constant reappearance of the traumatic memories and feelings associated with sexual abuse can be very tough to live with. With that in mind, here's the next question:

angeleyes: What is the best course of action when one is suicidal? What do you do with your patients?

Dr. Karen: I have been fortunate enough to have established a good enough relationship with patients early on, so when they become suicidal, I make them contract that they will call instead of follow through. Since I am in private practice, I make it a policy to be available by phone when necessary and expect patients to reach out when in crisis. This provides a great opportunity for them to learn how to trust. Don't be afraid to ask your therapist what their policy is about emergency phone contacts. The bottom line is (in good humor of course) I tell them, " I value working with you but I can't work with a corpse." This is hard work and we can wade through this difficult time if you're committed to the process. I also tell them, "you have survived this long. Your life is a gift. God isn't done with you yet." Folks, recovery is hard work and there are no easy answers. Having been a victim of ANY kind of trauma is a tragedy and it takes time to work through the issues.

David: I noticed some first-time visitors in the audience tonight. Welcome to HealthyPlace.com and I hope you will continue to come back. Here's the link to the HealthyPlace.com Abuse Issues Community. 

I want to thank Dr. Karen for joining us tonight. It's been very informative and I hope everyone found it helpful.

Again, thank you for coming and staying late to answer questions, Dr. Karen. And I want to thank everyone in the audience for coming and participating. I hope you found it helpful.

Dr. Karen: I was honored to participate. God bless.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

Heyward Ewart Ph.D., our guest speaker, devoted much of his 20-year career treating victims of child abuse. In his new book, "The Lies That Bind: The Permanence of Child Abuse," Dr. Ewart maintains that sexual abuse mangles the personality and introduces a "false self" that literally attracts predators throughout life.

David: HealthyPlace.com moderator.

The people in blue are audience members.

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Beginning of Chat Transcript

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "The Damage Caused By Sexual Abuse". Our guest is a psychologist and author, Heyward Ewart, Ph.D.

Dr. Ewart retired from a 20-year practice to devote himself to public education in the realms of domestic and child abuse and, more recently, the identification of dangerous students. He is a Diplomate of the American College of Forensic Examiners, and an adjunct professor of psychology at University of South Carolina. His new book, "The Lies That Bind: The Permanence of Child Abuse," is based on treating sexual abuse victims for his entire career. It contains graphic case histories demonstrating that abuse mangles the personality and introduces a "false self" that literally attracts predators throughout life.

Good evening Dr. Ewart, and welcome to HealthyPlace.com. Thank you for being our guest tonight. Are you saying that once a person has been sexually abused, the damage that has been caused leaves them open to further episodes of abuse?

Dr. Ewart: Absolutely. Such an event begins to mangle the personality so that the victim believes that it is his or her fault. The "my fault" thinking, is the biggest factor in people developing an attitude that it is their fault, and they deserve no better than being treated in an abusive way.

David: From what I've read, it is not unusual for the sexual abuse victim to reach a conclusion that the sexual abuse was her/his fault. In other types of crimes, that kind of thinking usually doesn't come about. How does that occur in the person who has been sexually abused?

Dr. Ewart: Usually, the sexual abuse is at the hands of a much older person. Children are taught that older people are good and correct and that children must learn from them. Therefore, if an adult does something that the child thinks is wrong, then the only conclusion is that it's "my fault". The trauma is directly related to the age difference.

David: You also used the term "false self". Can you explain in plain terms what that means?

Dr. Ewart: Yes. The original abuse will lead to further abuse, because of the attraction of predators. Predators, by their nature, attack wounded individuals. They are thus able to recognize wounded children, and they attack again.

As these incidents are repeated, the abuse tends to get worse and worse, and a kind of brainwashing takes effect so that the sexual abuse victim begins to believe that they were born to be abused and that they are equal to other people. It's the same type of brainwashing that happens in prisoners of war camps, where the captive's identity is broken down to the very bottom, and then they take on the identity that the captive or tormentor says they are. The biggest thing to understand is, that abuse is the strongest form of communication about one's self.

David: Given that scenario, the person's self-esteem at that point is almost non-existent and they are really a "broken" individual. What can be done to recover from that point?

Dr. Ewart: It would be deprogramming, and there are two stages in treatment. One is for them to understand how brainwashing works and how it worked on them. And then, they need to be treated for trauma because child abuse causes emotional trauma. When the victim understands clearly how these ideas about self were formed, they have the freedom to reject the lies.

David: Dr. Ewart's new book, "The Lies That Bind: The Permanence of Child Abuse," is based on treating sexual abuse victims for his entire career.

We have lot's of audience questions, Dr. Ewart, so let's get started:

smilewmn: How can I identify what is my "false self" and my "real self", so that I don't attract predators?

Dr. Ewart: The false self is intact and operating when predators are being attracted, and when you find that you can't break an abusive relationship. The true self is the one that expresses your individuality most completely, smilewmn.

lostgirl: How do we recognize predators?

Dr. Ewart: The very first indication is that a predator wants to own you, you become property, and you are treated as property. Possession is the opposite of love.

David: Here are a few audience comments on what's been said so far, then we'll continue with more questions:

helio: The worst part for me is when I confronted my family and they left me. Feeling "disposable" is the pain; being disposable to your own family of origin :( I know for sure that this was not my fault, but it took some time to realize this.

jellybean15644: I hear what you're saying Dr. When I was younger, I believed it was my fault and wondered what I did to provoke it.

Kassy: You should not have trusted someone so much.

sad_eyed_angel: I think that you are talking about children who are repeat victims of sexual abuse. I never, during my abuse, felt like I deserved the abuse that I was receiving.

LisaM: I have found myself attracted to men who are abusive, and though I have been in therapy for close to 5 years, I can't seem to break the pattern. Do you have any suggestions on how to stop this destructive behavior?

Dr. Ewart: Lisa: Number one, any therapy that goes beyond 6 months is useless because the prolonging of the therapy proves that the therapist does not understand the problem. Second, you must have a therapist that understands what abuse does and how it does it.

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anomaly: Are you saying that we can expect to undo in 6 months or less, the damage that has been with us all our lives?

Susan Maree: Are you saying it should only take 6 months to heal?

Dr. Ewart: Most definitely! Some people have gotten well since reading my book. It should take 6 months, or less because healing or understanding are the same things. Understanding the truth, because the truth will set you free. Prolonged therapy continues to drive home and confirm the victim mentality.

David: Dr. Ewart, in your experience of 20 years of treating sexual abuse victims, how many are able to reach the point where they are no longer "victims" for these predators? Even with therapy, it seems like a very difficult thing to overcome.

Dr. Ewart: My patients have gotten well within a few months. When the therapist understands the problem and understands you, the therapist can help you understand and accept the truth.

anomaly: I don't have a "victim" mentality. I've been in a supportive relationship for 4 years, but my self-esteem has been so damaged I don't know how it feels to have any.

Dr. Ewart: You are not over the trauma and you are probably having triggers that bring reminders of things that were said to you in the past and done to you in the past. Those flashbacks need to be treated so that they don't bring a feeling of worthlessness.

LeeAnnCx: I host a chat for survivors of sexual abuse and rape. One of the common problems some of the survivors of sexual abuse face is stopping the "it's my fault" thinking. How can a person stop this kind of thinking, especially if they don't have a therapist or access to one?

Dr. Ewart: LeeAnn, they need to understand, at the deepest level, why children take on the blame. Children take on the blame because they rule out the older person as being at fault and because other predators abuse them in other ways. The message that "I deserve it" is confirmed over-and-over. The brainwashing of a child is more permanent than the brainwashing of an adult, as though the message is carved into the bark of a young tree and as the tree grows so does the size of the message.

Let me add that there is a strong factor of obedience and for a brainwashed child to brand as lies the communication, would make the child feel like the ultimate traitor. The greater the abuse, the greater the obedience and the greater the loyalty.

David: Here are 2 similar questions:

teddyjan1: How do you reach the deepest level in a person, to tell them that they are worth something? How do you do that?

Dr. Ewart: I have that person do it, by encouraging them to explore any possibility of a talent or ability they have ever thought he or she might have, and the development of one's unique abilities begins to give a sense of self.

con_3_3_3: I understand why children take on the blame, and I still struggle with shame and guilt. The self-hate in me, and the feelings of being damaged are so deeply rooted. How does one stop that? I do not feel deserving of much of anything.

Dr. Ewart: con_3_3_3, when you get that feeling, ask yourself who's voice are you really hearing and who first told you that and how. Get in the habit of always identifying the voice.

David: As you can imagine, we have a few audience comments on what's been said so far. I'll post those and then we'll continue:

DeafDeb: I believe I understand, but I still think I have more healing to do.

freshoney: Being a survivor of sexual abuse obviously has trust factors, and I know that for me, it took 6 months just to begin to trust my therapist. Now, can you rush 38 yrs of damage?

con_3_3_3: Are you saying that 6 months of therapy can take care of one issue? Or are you saying that it is sufficient for multiple issues? I cannot see how one can be free of it in only 6 months. At least not in my case.

freesia: I totally disagree with the 6 months. I did not even tell my therapist until I had been to see her for 2 years. I had to build up enough trust in her and work through other issues. I was sexually abused 30 years ago and had never told anyone.

DeafDeb: I believe I have a good understanding, but healing seems like a lifelong process for me after all the sexual abuse.

Susan Maree: I am 50 years old and consider myself, not just a survivor, but a thriver. That doesn't mean I have no problems relating to the abuse. It means I'm human.

helio: Dr. Ewart, I have been in therapy and trying to deal with my sexual abuse by my older brother for many years. When people tell me to get on and over this thing, it hurts so badly I can't even tell you. Thanks for saying some of the things you are pointing out to me.

Dr. Ewart: The most hurtful thing people can say to you is "why can't you get over it". That drives the wound even deeper and more permanent.

Montana: Most of us, have many more issues to heal from than just the sexual abuse, and/or further issues the sexual abuse caused. Do you actually feel that everyone can heal from all their issues and be whole in this time limit? It takes times to feel even safe enough to reprogram, much less understand and forgive.

Bascha: I sometimes think I'm afraid to get better. Maybe that's what's stopping me.

Dr. Ewart: When I first moved to Florida, I brought a second-hand boat, and whenever it broke, I tried replacing that part to fix it. I ended up spending more in parts than I did on the boat. And then a friend told me you can't do that. You have to find the problem and then fix it. The same holds true in a way with the problems people have. Sometimes, multiple issues are really only a single issue. When people are empowered, they can solve their own problems.

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kit-kat: Do you have a specific therapy program that you use with sexual abuse victims and do you train other therapists to do the same?

Dr. Ewart: I used to, but don't do treatment anymore. I did treat people by means of group therapy, all women, with the establishment of complete safety, where no one is required to talk unless they wish to. I teach the principals of what abuse does, then the group interacts according to their experience. In addition to that, I individually treat the patient for emotional trauma, by desensitizing memories and by putting lies into the light of day.

Susan Maree: When you say "well" do you mean they are "normal" and have absolutely no problems relating to the abuse?

Dr. Ewart: No, I mean that they are well on their way to developing their individual abilities and establishing a strong sense of self, in addition to being able to recognize predators.

angelwoman: I have been in therapy and hospitals several times over the last five years. I also have dissociative identity disorder (DID) and I am nowhere near healing. How can you heal such a thing in six months?

Dr. Ewart: Good question, angelwoman. Usually, dissociative identity disorder is a misdiagnosis in the case of abuse and what seems to be DID is really the ramifications of emotional trauma. The diagnosis of DID is more of a philosophical concept than a reality.

weaverwoman: I would like you to explain what you said about DID. What do you mean that it is a philosophical approach? Are the alters a manifestation of people's imaginations?

Sonja: How is DID philosophical rather than a reality? Sure feels real to us!!!

Dr. Ewart: The alters are a few of the countless ingredients in everyone's personality. All of us are composed of many combinations of emotions and we tend to take on a different character when expressing a particular emotion. The truth is that everyone who has ever been born has multiple personalities. Human beings are the most complicated creatures imaginable. She, or you, may have thousands of alters, and I may have 1500.

David: One thing I'm finding in the questions Dr. Ewart, is that "6-month therapy deadline" is really a flashpoint for questions and criticism. Here's a for-instance:

LisaM: Dr. Ewart, seeing that I have been in therapy for 5 years now and that you don't think it is a good idea, should I just quit at this point? I am really confused.

Dr. Ewart: Lisa, do not quit unless you have something better. Don't start looking for a specialist in abuse and don't leave your present therapist unless you have confidence in a real expert.

delitenhim: I was sexually abused for many years as a child, have never had therapy and I am functioning. So why would it be beneficial to go?

Dr. Ewart: The fact that you are functioning demonstrates great strength of character, but for every action there is a reaction, and it is not necessary to continue to drag the baggage.

smssafe: How do you stop feeling unsafe. How do you regain feeling a sense of security?

Dr. Ewart: smssafe, the feeling unsafe, comes from the feeling of deserving punishment, probe why you feel you deserve to be punished.

David: Dr.Ewart, given that predators inherently know how to select their victims, is there a way for sexual abuse victims to identify the predator before she/he is taken advantage of again?

Dr. Ewart: Yes David; first, predators move very fast. Second, they will have either a strong or a very weak personality, one extreme or the other, and they will become possessive very early in the relationship.

David: Would you say that once you identify someone as a predator, run as fast as you can?

Dr. Ewart: I say run twice as fast as you can.

David: For those in the audience: Here's a question. Just send the answer to me. I'll post them as we go along. That way we can help each other.

Bascha: I find that I am open to abuse mostly from myself.

guardian: Yes, it makes you more vulnerable. Like the predator knows your weakness.

smilewmn: Yes, I feel like I have become more vulnerable and weak, and tend to succumb to what others want from me or want me to do, may it be sexual or not.

Montana: Yes, it did for me. I also got kidnapped, tortured, beaten and raped twice as an adult by perpetrators I did not know.

LauraM: I was told once by some friends, and then understood it was true, that I tend to be impolite to people who are nice to me and tend to be extremely nice to people who treat me badly. I had never noticed this until they told me so. Now I try to be conscious about it.

DeafDeb: There have been times that I felt I was a magnet for abuse.

freesia: Not further sexual abuse, but yes, as far as emotional abuse and physical abuse with other people and relationships.

Dr. Ewart: The nature of the predator has an uncanny ability to spot wounded prey and they always pursue them. A predator can spot a wounded woman a block away. And predators will never change, it's in their character. Like a hawk will never change into a dove, a predator will never change into a gentleman.

David: So it seems from some of these comments that Dr. Ewart has really struck a chord here; that sexual abuse really breaks down the personality, leaving the victim open for further sexual abuse.

Dr. Ewart: Yes, that's correct. That's exactly what I mean. The wounded draws more predators, and the person allows more predators because she believes she deserves no better.

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David: I'm wondering Dr. Ewart, if the further abuse has to be sexual abuse, or can it be emotional abuse or physical abuse too?

Dr. Ewart: All abuse has the same results. All abuse is communication at it's strongest form, and that is brainwashing.

David: Here are some more audience responses to my question:

If you have been abused; have you discovered that your personality has left you open for further emotional abuse, physical abuse, or sexual abuse?

marque: Yeah, to a point in my life. Then, I think I turned it inward in order to 'protect' myself from others.

wintersgold: Yes, I feel my personality has left me open for further abuse because I am twice divorced from abusive men.

bales_of_hay: Yes, very much so. The frustration with that though, is that you are constantly telling yourself that you would never let anyone ever do anything abusive to you again...but it always seems to happen.

MsJune: Yes, where one neighbor left off, about the age of 13, another one picked-up. Then I jumped into a relationship with a man I knew for hours, moved in with him, and found that he was extremely abusive. This followed a 2-year "fling" with a married man. He was 29, and I was 17.

Dr. Ewart: That's a perfect example, MsJune. Under the circumstances, you could not have done otherwise. Remember that there is no normal way to respond to craziness.

We B 100: I feel like I could still be controlled by my father (my abuser) mainly because he is so manipulative. Is this common among victims?

Dr. Ewart: It is universal, web100. Again, the greater the abuse, the greater the loyalty. That's the prisoner of war syndrome. Always remember that possession is the opposite of love, and that love always fosters freedom.

daffyd: Is the same pattern of abuse seen in men or boys who have been abused? Are most predators men, or are there women predators too?

Dr. Ewart: Good questions, daffyd. There are also women predators. There is a chapter in my book devoted to a man's life story. Little girls are abused more often than little boys but not by much. When boys are abused, they tend not to become abusive, but to be very sensitive to abuse and careful not to abuse others. This is the opposite of what most people believe.

marque: I wonder where those who were abused, who turn into abusers fit into this? Underlining the fact that I know they're a minority!

Dr. Ewart: They're simply an exception to the rule, marque. Let me add that some predators might be predators, no matter how they are raised.

delitenhim: Does a predator know they are a predator, or could it just be part of their personality?

Dr. Ewart: It's not part of their personality. It's part of their character. And they do know that they are a predator and they choose to remain that way. No form of therapy has proven to be successful in changing them.

David: Here are a few more audience comments on what's been said tonight:

wintersgold: Now, when someone seems to be "too nice", I run because I don't trust anymore. Nice equals hurt and pain.

guardian: My ex was abused and he was abusive to me.

LauraM: I have a question, Dr. Is it possible to actually become dependant on abuse? Many times I feel that I have developed a whole web around it hard to break because in some ways it gives a lot of support to many things in my life. It makes me take off responsibility for many things in my life. Can that be a reason for the constant "victimization"?

Dr. Ewart: LauraM, there's obviously a payoff to being a victim, and I don't mean this as an insult, but there are victims who choose to remain that way because it relieves them of all responsibilities. And I'm not saying that you are one of these people, but there are such people.

LauraM: I mainly meant using abuse as some kind of "crutch". I am a victim, so most things that happen to me or that I do, are not my fault. I don't say this to others, but to myself mostly. I am breaking that, but still sometimes think this way.

Dr. Ewart: That is the "my fault" mentality that is common in abuse. It sounds like you are trying to overcome the 'my fault' mentality, but not in a constructive way.

Jazzmo07: Is it worse, or the same, if one was sexually abused by both parents?

Dr. Ewart: I would say that it's worse, because it's crazier, and the degree of craziness determined the degree of reaction, Jazzmo06. And again, there is no normal way to respond to craziness. But seeing it as craziness does help.

David: Before we sign off, I want to invite everyone to visit the HealthyPlace.com Abuse Issues Community, and to sign up for the mail list at the top of the page, so that you can keep up with events like this.

I know it's getting late. Thank you, Dr. Ewart, for being our guest tonight. I think this conversation and topic has been very enlightening. From the audience comments, for the most part, it seems to have been helpful.

Dr. Ewart: Thank you. It's been an honor to be here. I wish power to every member here tonight.

David: It certainly brings the topic of revictimization to the forefront of our thoughts, and the need to realize that it can happen makes us aware that there's something we can do to prevent it.

I also want to thank everyone in the audience for coming and participating tonight.

Dr. Ewart: Good night all.

David: Thank you again, Dr. Ewart, and good night everyone.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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Beverly Engel is a marriage and family therapist. She joined us to discuss the emotional abuse of women, how to stand up to an abusive partner, get out of an abusive relationship, and even deal with emotional abuse in the workplace.

David Roberts: HealthyPlace.com moderator.

The people in blue are audience members.

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Beginning of Chat Transcript

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Emotionally Abused Women." Our guest is author and marriage and family therapist, Beverly Engel. Beverly has been in practice for about 25 years. She has also authored about a dozen self-help books, focusing mainly on women's issues. The one that may interest you tonight is entitled: Emotionally Abused Women.

Good Evening, Beverly, and welcome to HealthyPlace.com. We appreciate you being our guest tonight. So we're all on the same track, can you please define "emotional abuse" for us?

Beverly Engel: Emotional abuse is any type of abuse that is not physical in nature. It can include everything from verbal abuse to the silent treatment, domination to subtle manipulation.

There are many types of emotional abuse but most is done in an attempt to control or subjugate another person. Emotional abuse is like brainwashing in that it systematically wears away at the victim's self-confidence, sense of self, trust in her perceptions and self-concept.

David: Sometimes, we all take "jabs" at another person. At what point is it classified as "abuse?"

Beverly Engel: Emotional abuse occurs over time. It is a pattern of behavior rather than a one time incident.

David: Some people have difficulty determining if they are being abused. How does one know if they are being emotionally abused? Are there signs or symptoms we should look for?

Beverly Engel: Whenever you begin to doubt your perceptions or your sanity, when you become increasingly depressed, when you begin to isolate yourself from those who are close to you - all these are signs of emotional abuse.

David: What is it within ourselves that allows us to be emotionally abused?

Beverly Engel: Most often it is low self-esteem. Victims of emotional abuse usually come from abusive families where they either witnessed one parent abusing another or where they were emotionally, physically or sexually abused by a parent.

David: Let's say, for instance, that a person is being emotionally abused. What can they do about it?

Beverly Engel: The first step, as in most things, is to acknowledge the abuse. Then I recommend people go back into their childhood to discover who their original abuser was. This information will help the victim understand why she chose to be with an abusive partner in the first place.

She will also need to begin setting clearer limits and boundaries. More than likely, since she has not trusted her perceptions, she has been allowing her partner to walk all over her in many ways. Once she recognizes she is being abused she will need to let her partner know she will no longer allow such behavior. This does not mean he will necessarily stop but it will alert him to the fact that she is now aware of what is going on.

A woman who is being emotionally abused also needs to reach out for help. More than likely she has become isolated from others, perhaps because her partner is threatened by her friends and family. She needs to end this isolation in order to gain more strength and clarity, either by joining a support group, a chat room such as this one, or by seeking therapy.

David: You know, Beverly, many women are afraid to "stand up" for themselves and say, "please don't say or do those types of things to me anymore." One of the things they are afraid of is that the abuse might escalate or, on the other end of the spectrum, they might end up all alone without their spouse or partner.

Beverly Engel: Yes, these are real concerns. Sometimes emotional abuse can escalate into physical abuse. And sometimes standing up to an abuser will make him leave the relationship, but the price of staying silent is too big a price to pay.

When emotional abuse escalates into physical abuse, there are usually signs along the way that the other person is violent. If this is the case, it can be too risky to stand up to this kind of person. So I wouldn't recommend it. But a woman can still take a stand by leaving the relationship, by insisting they seek therapy, etc. If there have been no signs of violence, most women are safe in taking a stand. Emotional abusers push their limits. They will go as far as their partner will allow.

When they learn their partner will no longer allow it, some will back off. Others may try different tactics. Still, it is worth the risk. Many emotional abusers don't even know they are being abusive. They are merely continuing a pattern they themselves learned in their childhood, most likely from their family of origin.

Some emotional abusers are shocked to realize they are acting like their parents and some are willing to get help in order to stop the behavior, especially if they feel they will lose their partner if they continue to be abusive.

David: Here are a few audience questions on this subject:

Maera: My boyfriend just left me and I know consciously he is an abuser, but I want to call him so bad. It is like an addiction. How can I break that?

Beverly Engel: I suggest you take this time to focus on yourself if you can. Work on revisiting your family of origin to discover why you chose an abusive partner. Try to reconnect with old friends and make new ones. Try to keep yourself occupied in positive ways instead of allowing yourself to obsess about him.

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David: You mentioned a moment ago, that some men don't even realize they are being emotionally abusive. I'm wondering if you would categorize "emotional abuse" as being a "lesser" evil than physical or sexual abuse?

I ask that because some women just say "well at least he doesn't hit me."

Beverly Engel: Not at all. Emotional abuse can be just as damaging as physical or sexual abuse and sometimes even more so because the damage is so deep and all-encompassing.

When you are hit, the pain will subside a lot faster than emotional abuse, which continues to go around and around in your head endlessly. There is nothing worse you can do to a person than to make them doubt their sanity or their perceptions.

Emotional abuse damages your self-esteem and sense of self to such a degree that many women are unable to leave the situation for fear they cannot make it on their own. If you are told every day that you are stupid, that no one else will ever want you, that you are making things up you will not have the strength and courage to believe in yourself. Soon you'll feel like the only option you have is to stay with this abusive person.

David: Here's an audience comment that speaks directly to what you are saying, Beverly:

alfisher46: My husband will never leave me. He wouldn't have anyone to control. He's never hit me, but he has gotten violent and scared me. Yes, he refuses to believe he is abusive, then he is nice, then it starts all over again. He has my head spinning in circles. These bruises don't heal.

Beverly Engel: Yes, some women find comfort in the fact that a man will never leave them. These are usually women who were abandoned in some way when they were growing up - emotionally or physically. But again, the price you pay for knowing he will never leave you can be your very sanity.

paprika: If a person feels like they are walking on eggshells around their partner, are they most likely in a mentally abusive relationship?

Beverly Engel: Paprika - yes, this is exactly how women in an emotionally abusive relationship feel. They are afraid to say anything for fear of angering their partner. They are constantly blamed for anything that goes wrong. They feel like they have to be careful about everything they say and do.

oiou40: I was emotionally abused when I was an adolescent by my father. I have been in counseling three different times and the feelings go away for a bit but always come back. What can I do to really deal with them to the point that they no longer interfere with my life?

Beverly Engel: oiou40 - My first question to you is why have you been in therapy 3 times? Why did you stop therapy each time? Sometimes the answer to your question is simply that you need to stay in therapy longer and keep working on the issues with your father. It takes time to overcome emotional abuse, especially if you were a child when the abuse first began.

beth2020: How can you overcome the fear to take the first step? To stand up to someone is my biggest fear.

Beverly Engel: beth 2020 - I understand. Fear can be crippling. Perhaps you aren't quite ready to stand up to someone yet. Perhaps you need more time to heal from the emotional abuse from your past and to gain more self-confidence by surrounding yourself with supportive people.

Keep trying Beth. It takes time to gain the courage and confidence to stand up for yourself. You can start by leaving a room or your home when the abuse begins. That way you won't be adding more abuse to your already wounded soul.

David: I think that's a good point, Beverly. You don't have to stand up to anyone to get help for yourself. You can still get therapy, attend a support group, and see supportive friends without confronting the abuser.

Beverly Engel: Yes, standing up for yourself may be the last step, especially if you've tried in the past and were knocked down (emotionally or physically).

David: Here's a comment from another audience member facing a difficult situation:

alfisher46: I'm still in denial about being abused because it doesn't happen all the time, but he has threatened me and threatened to take my daughter. He's got me right where he wants me. I'm scared to come home. I never know if he will be happy or mad. I have learned how NOT to set him off - by keeping my mouth shut. I keep telling myself I need more time also, but I keep getting depressed.

Beverly Engel: Alfisher46 - Yes, when an abuser threatens to take your children they do have you where they want you, but in most cases, that is all it is - a threat. Legally, he more than likely will be unable to gain full custody of your child.

The longer you stay in the relationship the less strength and courage you'll have to leave. And you do need to consider your daughter's welfare. She is being emotionally abused by being in his presence as he abuses you. She is learning very bad lessons about relationships by watching you and your husband interact.

I know it is difficult but you do need to continue working on coming out of denial and you need to seek some help. A good therapist will help you gain the strength to leave. I am concerned about the fact that you say you are depressed. This is not a good sign at all. Please seek some help.

David: I remember at the start of the conference, you said emotional abuse can really wear the victim down. I'm getting a lot of comments from people who are "too emotionally worn down" to do anything positive to help themselves. What would you suggest to those people?

Beverly Engel: I suggest they seek professional help or join a support group. You may not be able to do this on your own. There is no shame in saying that you need help.

I am not trying to drum up business, but I do offer e-mail counseling and I am willing to help anyone who has more questions after the conference is over.

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David: Beverly's website is here: http://www.beverlyengel.com

Her book, Emotionally Abused Women, can be purchased by clicking on the link.

Beverly also has a companion book entitled Encouragements for the Emotionally Abused Women which lets you know that you are not out there alone and is designed to lift your spirits and focus on positive growth.

Here's the link to the HealthyPlace.com Abuse Issues Community. You can click on this link and sign up for the mail list on the side of the page, so you can keep up with events like this.

We have a lot of questions, here's the next one:

Betsyj: What if, in a marriage, the abuse was going both ways from both partners and now, as I am separated on my way to divorce, I feel like I nitpick everyone I meet?

Beverly Engel: This is a very common problem. I am glad you are aware of your nitpicking because now you can begin to change. I suggest you look at the following possibilities:

1. Have you become involved with someone who is rather passive and have in essence, turned the tables and are now the dominant person in the relationship?
2. Do you have a great deal of anger left over from the previous relationship that you are now taking out on your current partner?
3. Do you need more emotional and physical space from your partner than you are getting - are you feeling smothered? Sometimes we nitpick so we will start a fight and gain some distance.

GreenYellow4Ever: How can we help women (maybe our own mothers or sisters) if we see that they are being emotionally abused?

Beverly Engel: Good question, GreenYellow. While they might not be completely receptive to it, I suggest you tell them directly if you think they are being emotionally abused. Explain what emotional abuse is since many people don't really understand it, then offer support.

David: We've been talking about emotional abuse at home or in personal relationships. Here's a workplace question, Beverly:

rikki: How would you handle emotional abuse in the workplace?

Beverly Engel: It is difficult since you certainly can't confront a boss or manager very easily, not without risking your job, that is. But if the emotional abuse is severe enough, there are steps you can take, such as making a complaint to personnel or employee relations. In most situations, however, you need to remind yourself that this person has problems and that what he or she is saying to you is not true.

The primary reason why emotional abuse is so effective is that we tend to buy into what the other person is saying and start to doubt ourselves. Get some outside support so this doesn't happen. Talk about the problem with friends so you can get some feedback.

If you are being emotionally abused by a coworker, you can stand up for yourself without risking your job. Simply tell the person that you don't appreciate what was said or that you found their behavior offensive or hurtful. You can add that you assume they didn't mean to hurt you but you would appreciate it if they would stop. This way they won't tend to become as defensive.

The bottom line is - if the emotional abuse is severe, you may need to leave the job rather than allow it to damage you emotionally. No job is worth that.

David: And if it's your boss or manager, and you address the issue, I'm assuming that you would advise the person to have a "plan B" and keep in mind they may have to start looking for another job.

Beverly Engel: Yes. Most bosses who are emotionally abusive are not about to stop simply because you stand up for yourself. In fact, they may increase the abuse. So yes, know that you may need to seek another job.

chinchillahug: I was emotionally abused by a trusted church pastor. He became very controlling. Now, even 3 years after that relationship ended, I'm still plagued with anger and distrust. I am wary of male authority. I've been in therapy but I can't shake the anger. It poisons my being.

Beverly Engel: Are you still in therapy? If not, I suggest you go back into it. You didn't say how your pastor abused you. Was there a sexual relationship? Were you working for him?

chinchillahug: Emotionally abuse, no sexual.

Beverly Engel: I also suggest you discover who your original abuser was. Some of your anger may actually be at this person in addition to the pastor.

David: I know it's getting late. Thank you, Beverly, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful.

Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others. http://www.healthyplace.com

Thank you again, Beverly.

Beverly Engel: Thank you for the opportunity to connect with your audience.

David: Good night everyone and I hope you have a pleasant weekend.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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Dr. Jeanie Bein our guest, who is a licensed psychologist and specializes in abuse, trauma, and family problems will be discussing and answering questions dealing with domestic violence and domestic abuse and how to become free from the cycle of abuse.

David Roberts: HealthyPlace.com moderator.

The people in blue are audience members.

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Beginning of Chat Transcript

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Domestic Violence, Domestic Abuse." Our guest is therapist, Jeanie Bein, Ph.D., in Denver, Colorado, who specializes in abuse, trauma, and family problems.

Good evening, Dr. Bein and welcome to HealthyPlace.com. We appreciate you being our guest tonight. Why is it that we find it so hard to break out of destructive relationships?

Dr. Bein: I believe that one of the most difficult tasks of humanity, is to become free from the cycle of abuse. People get stuck in the victim role for a number of reasons. Usually fear is a prime motivator:

• fear of what the abuser will do,
• fear of being alone,
• fear of taking a proactive step.

Many people believe that they are bad, and this is what they deserve. They get this message from parents when they are children. They observe their main role models in abusive situations. This is what they know, and it is difficult to change patterns.

David: Is "being a victim" a learned behavior from childhood, or is it something that develops as a result of the fear instilled by the abuser?

Dr. Bein: Sometimes both, and sometimes neither one. Victimhood is often learned from the way parents treat their children and sometimes it happens later in life.

David: What draws these individuals into abusive relationships? On the surface, it seems it can't be attractive for them.

Dr. Bein: Perhaps they are looking for someone like their abusive parent, although, they don't consciously realize they are doing this. Often these folks feel fearful and insecure and find a mate who can give them answers or take charge, not knowing the extent of the taking charge. In the cycle of abuse, one form of abuse is self-abuse. One form of self-abuse is being paired with a perpetrator.

David: Just to clarify here, what is your definition of an abusive relationship?

Dr. Bein: An abusive relationship can mean that one person takes another's power or violates another's boundaries.

David: Dr. Bein's website is here.

Psychologically, what does it take for an individual to break out of an abusive situation?

Dr. Bein: In a word, "empowerment." One must realize that they are in an abusive situation. They must want to make a change. They need to make some personal, internal changes, to increase self-esteem. Some people need professional help and support to make the change. Others are able to do it on their own. Then they need to take action in the most expedient manner possible.

David: What are your thoughts about going to a battered women's shelter or someplace similar?

Dr. Bein: Sometimes that is the best answer. Shelters offer protection and allow the abused person to hide from their abuser. In some situations, it presents a practical problem, in that someone with a career may need to drop out of their job and economic support when making this change. It depends on individual circumstances. Sometimes it is best to call the police and have the abuser physically removed, then take out a restraining order.

David: We have some audience questions, Dr. Bein. So, let's get to a few of those:

bunchie5: Don't they ever see the light and realize that they are abusing us emotionally?

Dr. Bein: A typical pattern is for the abuser to "see the light" after perpetrating the abuse. It's roses then. Often they are just as trapped in the cycle of abuse, as is the abused (not that this excuses them). I think it is more difficult for the abuser to change, and would need more professional help than it is for the abused to change.

secretsquirrel: How do you break the cycle of abuse when that is all you know? I feel so afraid and alone.

Dr. Bein: If one is afraid, alone, and doesn't know how to break the cycle, if they can't afford to seek out private help, they should go to a shelter for help. One can receive counseling at a shelter, even if they are not ready to go there to live.

Alohio: Aren't abusers normally wimps, inside? As such, how does one best deal with them?

Dr. Bein: Abusers are in a cycle. They feel abused themselves. So they need to put others down. You are right! Abusers are usually cowards when they come up against someone more powerful. The domestic abuse builds them up, just for a moment, then they feel even worse about themselves because of what they have done.

David: One of our audience members, NYMom, is being abused by her son. She says he has punched her several times and given her a black eye. He threatens to repeat the physical abuse if she doesn't do what he wants. He received a kidney transplant, as well, and she's afraid to leave for a shelter because she is worried about who would take care of him. By the way, her son is fifteen years old. What would your suggestion be, Dr. Bein?

Dr. Bein: She should call in the authorities, and make them do their job. This has to stop as soon as possible, or it will get worse. She can't stop it on her own, so she has to get help. She should call the police. If he doesn't take the consequences for his behavior, he won't ever learn! Getting tough is the most loving thing she can do! The authorities can and must deal with the medical issues.

bunchie5: My husband can be so nice when he wants, or I should say, when he feels he is losing me. I feel like he throws the line out and reels me in repeatedly. However, this niceness only lasts no more than three to four days. Once he thinks he has me back, he turns into the monster again. I can see the pattern now with him. I want to get out of this, without having to hear the begging and crying from him that he is sorry and will never do it again.

Dr. Bein: If you are really ready to assert your rights, then I suggest that you call the police when he hurts you, then get a restraining order. If you feel that you would be in danger, then go to a shelter. However, you have to stay tough, and not back down when he is nice and goes through the "roses" phase.

secretsquirrel: Can you ever "get over" the effects of past abuse? They seem to be the hardest.

Dr. Bein: Yes, you can! Some people do, and some people do not. It may be wise to seek professional help for this one.

Lumpyso: I was abused many times as a child. Recently, I was assaulted by a stranger and I want to know how these people find me. Why am I susceptible to this kind of treatment?

Dr. Bein: This may be hard for you to hear. I must first say, Lumpyso, that it is not your fault! Yet somehow, and you probably don't know how you are doing it, but you are sending out messages that you are fearful. This may be your body posture, closing yourself in front with your arms, the way you look at someone, or other non-intentional ways that you show you are powerless, however, this is correctable!

David: By the way, Lumpyso, and everyone else here tonight, we had a great conference on just that subject -- why those who have been abused are open to re-abuse and what to do about it. The transcript is from our conference on "The Damage Caused by Sexual Abuse."

Here are some audience comments on what's being said tonight, then we'll continue with a few more questions:

Goodmomma2000: I surely know that one! I found out after my husband died, that he was a child sexual abuser. I'm so mad that if he weren't already dead, I would bump him off!

secretsquirrel: I understand what Lumpyso said. It seems like child sexual abuse makes you a target for life.

cosset: I was told that since I didn't leave the house and go to a women's shelter that I was not afraid of my husband. So, the abuse my husband dished out was not accepted by the courts in the divorce process.

Dr. Bein: Hey Cosset, that makes my blood boil. That is the old way of blaming the victim!

David: When is it time, Dr. Bein, for someone to say to their abuser, "I'm not giving you any more chances?"

Dr. Bein: Now is the time! It is time when one realizes that one just can't stand the abuse any longer, enough to want to do something about it. For me, I would not give someone a second chance if I were hit.

Alohio: How many abused women feel they "deserve" what they get because they are females? How can they find they deserve better?

Dr. Bein: Alohio, I think that a lot of abused women feel they deserve it. The abuser tells them it is their fault. They may have heard this from their abusive parent. This idea that the victim deserves the abuse, somehow brought it on her/himself, is changing. But it is difficult to break out of a mindset one has had all their lives.

David: Here's the link to the HealthyPlace.com Abuse Issues Community. You can click on the link and sign up for the mail list at the top of the page so you can keep up with events like this.

Dr. Bein's website is here.

Here's another audience question:

julybaby: Dr. Bein, my twenty-two-year-old daughter is in an abusive relationship. She has been physically ill and is afraid that if she doesn't have sex with her boyfriend, he will go find it somewhere else, so she gives it to him. How can I get her to understand this is unhealthy?

Dr. Bein: It may be hard to get through to her. Because at her age, she may feel that she has a right to live her life the way she chooses. However, you can point out to her that she deserves more. Explain that her body is hers and hers alone, and that no one has a right to take anything from her that she isn't comfortable giving. Tell her that she is setting herself up for more abuse. She is making a statement to him that he can treat her this way. If he loves her, he wouldn't make her do what she does not want to do. So, therefore, he must not love her. Somehow, you need to help her feel loveable and worthy, and furthermore, sex is not love.

julybaby: I agree. I have told her, and she had witnessed me being abused. You would think that she would learn from my experiences.

Dr. Bein: Actually, she may have learned to be a victim from watching you. This is what she saw and learned as an impressionable child. The best thing you can do is to be a role model of empowerment to her.

milkman: Dr. Bein, I am a victim of domestic violence and can't seem to find any help. You see, I am a male and the abuser is my sister. Can you direct me?

Dr. Bein: How old are you? Do you live in the same house as your sister?

milkman: I am forty -two years old, and no we don't live in the same house, but we both work for our parents on their dairy.

Dr. Bein: There are several ways you could approach the situation. First, try talking with her and confronting her. Tell her that you will not put up with it any longer. You could ask for your parents to intervene. You may then wish to call the police and charge her with assault and battery. You may also consider getting another job.

David: What kind of abuse is your sister inflicting on you?

milkman: Verbal, physical, and mental abuse.

Dr. Bein: Perhaps with some professional help, you could learn how to confront her in an effective way to stop the verbal and mental abuse.

starlight05: A few months ago, I told my husband that I wanted a divorce. He has not paid our mortgage since, even though he has the money. I think he is doing this to show me who is in control. My home went into foreclosure and he paid all back payments, but not after letting me know that if I ever left, me and our children would be in the streets. What are my options?

Dr. Bein: He is trying to scare you and intimidate you. You have rights and I suggest that you see a lawyer to find out what the rights you have. For example, he is required to pay child support, and perhaps alimony. If you take him to court, you can also ask for him to pay court costs.

David: I know it's getting late. Thank you, Dr. Bein, for being our guest tonight and for sharing this information about domestic violence, domestic abuse with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have a very large abuse survivors community here at HealthyPlace.com. If you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others. http://www.healthyplace.com.

Thank you again, Dr. Bein.

Dr. Bein: Thank you for inviting me onto your program. Thank you all, and Bless!

David: Good Night everyone. I hope you have a good weekend.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

THE NEW "BLACK BOX WARNING" ON ANTIDEPRESSANTS: WHAT DOES IT MEAN TO ME AS SOMEONE WITH DEPRESSION?

On May 2, 2007 the FDA required a label change for antidepressant medications. This was the second time such a change had been required. The first was in 2004, when the FDA required that a black box warning (the most serious warning) appear on the package insert advising of a possible increase in suicidality in children and teens taking antidepressant drugs. The most recent action increased the age of those included from below 18 years to age 25.

As a clinician, I have already heard from many patients and family members worried about this recent change. Their concern basically is "what does this really mean to me or my loved one? Should we avoid taking the depression medicines, or stop them?" Before answering this concern, let me acquaint you with the background that led to the change.

WHAT IS A BLACK BOX WARNING, ANYWAY?

In the package insert sheets that come with a box of medication (which is usually thrown away by the pharmacist before you get the medicine), there are warnings about the use of the drug being prescribed. The strongest of these warnings is a "black box warning" (called such because of the bold black border around the wording). It is rarely read by patients, but news reports or patient brochures often mention the warnings. The "black box warning" for children and adolescents taking antidepressants can be found here. This FDA mandated wording warned of the possibility of increased suicidality and other symptoms which might be experienced by patients early in treatment with antidepressants. Beside suicidality, the following other symptoms might appear:

• increase in anxiety or panic attacks
• trouble sleeping
• worsening anger-irritability or aggressive behavior
• abnormal increase in activity or talkativeness, or "other unusual changes in behavior."

SO WHAT IS SUICIDALITY?

Suicidal refers to thinking of taking one's life, or actions towards this end. It is not the same as suicide itself. In fact in the 4400 children and adolescents studied in the clinical trials that led to this warning, there was not a single suicide. So, it was rather an expression of suicidal thinking or behaviors, rather than the actual taking of one's life, that was being referred to.

During the trials, in the group of children and adolescents on active antidepressant drug, there was a doubling of suicidality compared to those on placebo (sugar pills). That sounds ominous until one looks at the real numbers-4% on active drug vs. 2% on placebo. Increased to be sure, but not in actuality by a large number. That means in a group of 1000 kids taking the antidepressant drug, the number with suicidality is around 18. In the young adults aged 18-25 studies, it was an additional 5 cases of suicidality. No increase in suicides, but in suicidality. By the way, in adults over 25 there was no increase in suicidalty and in seniors age 65 and above, there was actually a decrease in suicidality.

THE IMPACT OF THE CHILD/ADOLESCENT WARNINGS

Since the warnings were instituted, there has been a marked decrease in the number of kids for whom antidepressants have been prescribed. At the same time, there has been an increase in actual suicides in this age group (8%↑ in ages 10-14, and 12%↑ in ages 15-19). This information does not necessarily demonstrate cause and effect, but is alarming. The job of physicians who treat children and adolescents has become particularly difficult as family members have become more alarmed at the information and news reports of the warnings.

WHAT CAUSES THE INCREASE IN SUICIDALITY?

Experts are not in full agreement about the cause of the increase in suicidality when taking antidepressant medication, but there are several theories, the most prominent being:

• early change in brain chemicals effected by antidepressants
• early side effects caused by antidepressants
• and the use of antidepressants in patients who are really suffering from bipolar depression.

I will talk about all three, but first want to mention that the risk for suicidality is greatest during the first several weeks of treatment, or shortly after an increase in dose.

EARLY INCREASE IN BRAIN CHEMICALS: Most are familiar with the fact that the modern day antidepressants that effect serotonin do so by increasing the amount of the neurotransmitter in the space (synapse) between brain nerves (neurons). Research has shown that initially there may actually be a decrease in the amount of serotonin released to the synapse, and this decrease may last for several days to weeks. One theory of suicidality is that this decrease may lead to suicidal thinking.

EARLY SIDE EFFECTS OF ANTIDEPRESSANTS: Early in treatment, the modern day antidepressants can cause in some: increase in anxiety, worsening of insomnia, agitation, and a feeling of need to move about caused by a feeling of needles and pins in the legs and feet (a symptom known as akathisia). These symptoms are usually temporary and most often are gone within a few days to weeks. They can be treated if they are bothersome, but if not reported or recognized can lead to an increase in suicidality.

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OVERLOOKING BIPOLAR DEPRESSION: Most of our readers are now aware of the existence of bipolar disorder, in which patients have one or more episodes of mania or hypomania in addition to symptoms of depression. In some patients it is not the speeded up manic phase that presents, but the depression which shows up initially, and only later can the diagnosis of bipolar disorder be made with accuracy. The "so what" of this confusion between unipolar and bipolar depression is that the use of usual antidepressant medications, although "right on" for the treatment of unipolar depression may cause problems for those with bipolar depression. Some of those with bipolar depression can be "flipped" into a hypomanic or manic episode which can present with agitation, increased movement and thought, and increase in suicidal thinking.

MOST IMPORTANT: Depression is a disease that can tragically result in suicide. In addition, the physical, occupational, and social impact of depression can be huge, as depression affects not only the patient but family, friends and coworkers as well. In addition, new research shows that patients with depression are more likely to suffer and die from a variety of other diseases. Antidepressant medication can reduce both the suffering and the risk of death from suicide, and can decrease the likelihood of death from other medical illnesses as well.

SO WHAT TO DO?

As a patient or "concerned other," I believe it is important to understand the intention of the FDA warnings regarding antidepressants à ¢Ã¢â€š ¬Ã¢â‚¬Å“to alert us to the possibility of suicidality and other symptoms during early usage or dose increases of antidepressant medication. Certainly notify the physician if these symptoms appear, and ask for appropriate help in dealing with them. Remember that the decision to use antidepressants, or any treatment, is ultimately up to the patient or guardian-and that this decision should always be an "informed one" - always weighing the risks of non-treatment against the benefits of the medication or therapy recommended.

by Harry Croft, MD
Medical Director of HealthyPlace.com

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Harry Croft, MD is a practicing psychiatrist and medical researcher. He also conducts clinical trials on behalf of American pharmaceutical companies and is Medical Director of HealthyPlace.com.

back to: Dr. Harry Croft's News Index

http://www.healthyplace.com/news_2007/croft/warning_antidepressants.asp

It's nearly impossible for a group of parents to get together without talking about their kids. And since few people will admit their little angels ever struggle with problems, the myth of picture-perfect families continues.

Massachusetts sisters Gina Gallagher and Patricia Konjoian, both moms, have had enough of perpetuating perfection. In fact, they are likely to wear T-shirts that read: "Shut Up About ... Your Perfect Kid!" It also is the title of their new self-published book.

"They're the mothers and fathers of the perfect kids. We've all seen and heard from them," they write. "They are in our cities and towns. On the soccer fields. At swimming lessons. Behind the bulletproof glass at ballet class. You know them - the ones who drone on and on about how smart, athletic, gifted and talented their children are. Blah, blah, blah."

The duo are on the front lines of what they describe as "the movement of imperfection." Gallagher and Konjoian set out to give a voice to parents of children with conditions such as attention deficit disorder, bipolar disorder, Down syndrome and autism who think their kids are pretty neat, too.

Gina's daughter Katie, 12, has Asperger's syndrome, a psychiatric disorder characterized by impairments in social interaction and repetitive behavior problems. Patricia's daughter, Jennifer, was diagnosed with bipolar disorder at age 8. She is now 14.

Their Web site, www.shutupabout.com/, is a place for like-minded parents of "imperfect" children to share their experiences. Their book ($15.95) can be ordered from the site and at Amazon.com.

The sisters say despite living in the same neighborhood or attending the same parent-teacher meetings, they feel "worlds apart" from other parents.

"And if it's not bad enough that we have to listen to them, we have to read the bumper stickers on their minivans and SUVs," they write.

Here's their response to those bumper stickers:

Theirs: "My honor student loves me."

Ours: "My bipolar kid loves me and hates me."

Theirs: "I'm spending my soccer star's inheritance."

Ours: "I'm spending my kid's inheritance on co-pays."

I asked the sisters if they ever ended a friendship because a parent wouldn't be quiet about their perfect child.

"Not so much ended a friendship as distanced ourselves," says Patty, of Andover, Mass., in a recent conference call with the sisters. "On your darkest days, you want to talk to people in similar situations because they understand.

"Jennifer is doing better, but I still go to a support group. You never know when the bottom is going to drop out. Jennifer is a good inspiration to those parents who have children who are newly diagnosed. Mental illness is treatable."

Both women had the blessings of their daughters to write their book. Gina, who lives in Marlborough, Mass., says it was hard to write about an incident that happened to Katie on her eighth birthday. Katie and her classmates were competing against another team during an egg-and-spoon race.

Katie dropped the egg and headed in the wrong direction. Her teammates shouted, "She can't do anything right!" and "She's making us lose."

Gina tried to convince her daughter to leave, but Katie wanted to stay.

"When I got in my car, I sobbed like a baby," she writes. "And six days later, on my birthday, I was still crying."

The sisters interviewed many parents of special children.

"We've talked with parents whose children may never walk, talk or ever live with them at home," they write. "These parents have missed out on little events and milestones that so many of us take for granted. Yes, even in our perfection-crazed world, we found warm, wonderful people who had the courage to be real."

Source: McClatchy Newspapers

Females are bucking the traditional drug abuse trends when it comes to prescription drugs such as antidepressants and tranquilizers.

Normally, usage rates for illicit drugs such as marijuana and cocaine are much higher for men than women. But for prescription drugs, the reverse is the case for teenage girls, said the White House Office of National Drug Control Policy.

Nearly one in 10 teenage girls reported using a prescription drug to get high at least once in the past year, officials said Monday. For teenage boys, the ratio was close to 1 out of 13.

Federal officials theorized that the trend reversal may be due to unique pressures faced by girls. Men typically abuse drugs and alcohol for the sensation, while surveys indicate women do so to increase their confidence, reduce tension or to lose weight.

"Too many Americans, and increasingly, too many young women, simply do not know the addictive potential of these medicines," said John Walters, director of National Drug Control Policy.

The usage trends for prescription drugs were pulled from the 2005 National Survey on Drug Use and Health.

Officials said females are involved in 55 percent of the cases of emergency room visits involving prescription drugs. That percentage drops to 35 percent for women when street drugs are involved.

Source: Time

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