The Power of Free Speech
St Joseph’s Industrial College, Galway
I was asked to write a piece about my experience of working with survivors of child abuse in Ireland. I wrote this response in the week that Salman Rushdie was attacked. It also happened to be an anniversary of my move to Ireland in 2000. It was a dream come true for me to work in Ireland. I lived in Galway. I returned to the UK in 2017 for family reasons. It was difficult to leave Galway. I now have two homes and move between UK and Ireland regularly.
To the work. I was part of a team of 10 Directors tasked with setting up a counselling service primarily for survivors of institutional abuse. It was soon opened to all survivors of all types of abuse in the community. This was to be a free, confidential, and easily accessed service. Free telephones lines to access services all over the country were put in place. Whilst provided within the health service the aim was to be as non-institutional and user friendly as possible. 10 teams were recruited to operate from many locations. It was named by the 10 directors who all worked together, as the Nation Counselling Service (NCS). I was lucky enough to work in the west, covering counties Galway, Mayo, and Roscommon. It was a privilege to be included and I worked there from its opening in 2000 until 2011.
The service remains in place today. It is highly professional and much valued by its service users. Continual systems of research and governance were assisted and supported by service user groups which existed country wide. Over the years the service has adapted and changed to meet the needs arising from both service users and the Health Service Executive (HSE – The Irish Health Service).
In 2000 Psychotherapy as a profession was fairly new in Ireland. Psychiatry and Psychology services however were available nationwide. The existing NGOs like Rape Crisis, Relate, Aware, and latterly One in Four and others had hitherto been providing services for survivors. This was a fairly charged political arena in which to place a new service.
The new service received funding from the HSE because of massive publicity surrounding a Documentary, by Mary Rafftery called “States of Fear “. Institutional survivors were given the opportunity to disclose their suffering and tell their heart-breaking stories, for the first time on national TV. Ireland, like many other countries had to face and bear witness to the terrible abuse that had occurred for many years, endured by many thousands of survivors in government/church led institutions.
https://www.thejournal.ie/readme/states-of-fear-5024180-Mar2020/
Many survivors did not survive, having died by suicide or poor physical health as result of malnutrition and physical abuse. Many found their way to and through the prison service and the homeless services. The NCS was in some ways, for some clients the last port of call. Many of them told us this.
The Tuam babies story is a horrifying example of this.
Much of our initial work in the west involved liaising with the existing services and working out how we would incorporate the new service and begin to share our clients.
Predictably we had waiting lists within 3 months in Galway and in most highly populated areas. Contracts with clients were open-ended. The early research showed that the clients preferred the medium-term contracts of 20 to 40 sessions. For some, one session was enough. The story told, they wanted to leave it there.
Many clients presented with complex trauma patterns. All therapists were required to have two qualifications including specific training in sexual abuse. Strict safeguards were put in place for staff, for example limited exposure; 16 sessions per week, on-going clinical and separate management supervision. Emphasis on further training and Continuing Professional Development. We wanted to ensure safe practice and maximum and effective support for clients. We attended to the risks to staff of vicarious traumatisation. The work with clients was often a harrowing experience. The courage shown by these clients was profound.
As therapists we bear witness to the suffering. Abuse is a very lonely experience more especially when other adults are complicit either by being abusive themselves or by ignoring what was occurring around them. What does a young cleric do when all his seniors are involved in pattern of abuse? When children told their story they were not believed.
In therapy they told it and they were believed, and this in itself was hugely healing for many.
After several years of work with a very traumatised client they proudly told me that I was now included in their flashbacks, “In the flashback I am cleaning the floor on my knees, my abuser is behind me, watching me, and you are there now, watching him”.
My personal experience of the effects of this work was insidious and long lasting. I made the mistake of having a case load and managing. In retrospect I think looking after the staff was the part of the part of the job that suffered. I loved the work with clients. I had a long-term group in the final years which was very powerful and which I have written about previously.
After many years in the role, I became traumatised. Despite all my efforts . . . very good supervision. Training in empathy, somatisation, Babette Rothschilds, work was very helpful.
http://www.somatictraumatherapy.com/the-body-remembers-an-interview-with-babette-rothschild/
I also found Gabor Mate and his work on working up with trauma and addictions, wonderfully insightful and empathic – The Wisdom of Trauma in the link below is a helpful film.
https://thewisdomoftrauma.com/
To offset the possible vicarious effects I swam every day, practiced meditation, walked the promenade in Galway, spent a lot of time in mountains and beautiful scenery, talked with family and friends, great friends I made in Galway. I had a lot of love coming my way. Eventually, my family began to ask me to leave the job in the final few years. They told me that I wasn’t so much fun as I used to be. I recognised that.
Pearl and Saak-Vittne recommended long breaks and sabbaticals . In their research with trauma therapists, they recognised that this work disturbs our spiritual life and our belief in the power of goodness. They say it is deeply disturbing for the soul.
https://www.massey.ac.nz/~trauma/issues/2001-1/steed.htm
This is very similar to what our clients told us about having endured this kind of suffering. I knew, after several years, that I was beginning to experience these effects.
I was raised as an Irish Catholic. I was lapsed long before I started this work. For a time, I had an unbalanced view of clergy. I was very untrusting. My sympathy was one sided.
The abused client. I had little time for the suffering of perpetrators, until it came into the therapy room, alongside the abuse story. Then some further training was required.
After 11 years I knew That I needed to stop the work. I took early retirement. I think I did have a degree of vicarious traumatisation. After a six month break, I started a small private practice in Galway for a further 6 years. I fully retired when I returned to the UK in 2017.
Below I list a few things that I am left with. I am sure many trauma therapists also cope with these struggles.
A suspicion of men with children . . . this includes parents in my gym, scout leaders, swimming coaches, random families.
Harshness in my mind about clergy, having very little respect particularly for bishops who did not listen when told what was happening.
No time for the Vatican.
A struggle with the incredulity of so many that covered up, ignored, and denied what was staring them in the face when children were being harmed.
Huge difficulty when hearing adults berating and shaming their children in public.
Great sadness when hearing babies left to cry in any context, often in my gym.
Hypersensitivity to the inevitable sufferings of ordinary childhood when with my grandchildren.
Avoidance of any media dramas involving trauma except medical series.
Avoidance of the news unless I can read and filter it.
Also troubling is that I have flashbacks of things told to me by clients. I feel a bit ashamed of this as if there is something wrong with me. They happen a few times a week. They are decreasing as time goes by.
What I think I have learnt since working in this arena:
This work will break your heart.
We cannot unknow things.
Some things we have heard we will never forget or repeat necessarily.
As therapists, we must believe the unbelievable.
We lose a lot of innocence in the work.
Survivors can tell you what happened to them without using words . . . look for signs like gagging, constant clearing of the throat.
Clients should not be asked for details about the trauma. On the other hand the therapist needs to convey a willingness to hear the detail so that it can be shared and witnessed fully.
We all have the potential to abuse.
I need to be vigilant with myself and be aware of my shadow.
I need to be vigilant about my own self-destruct button, always lurking and urging me to fail in some way.
My former clients live in my head. Like friends, loved ones, I converse with them a bit. I remember them fondly.
I would not have survived the work without the help of many:
The past and present Directors of Counselling and staff in NCS
Supervisors
Nancy McKenzie
Dr Maureen N Neulon, Galway
Dr Helen Greally, Galway
Jacinta Kennedy and Katie Woollet, Dublin
Ann O’Neill, Clare
Seamus Mannion, Galway. My manager who supported everything I did.
Great Friends and great family
Special thanks to a Patrick McGrath RIP my training group analyst who told me about the jobs coming up in Ireland and sent me on with huge encouragement. A very special man.
I have found my spiritual home as a Quaker attender. In St Albans Quaker meeting.
There I can search in silence for my equilibrium and my god.
These are some of the writers whose work helped me, some mentioned in the links above:
Freud through Trauma Training at The Tavistock London
Gabor Mate film: The Wisdom of Trauma
Babette Rothschild
Pearl and Saak-Vittne. Trauma and The Therapist
Bolas. The Unthought Known
Winnicott
Bowlby
Many many more.
Theresa trained at Turvey. She is a retired member of IGAS and IGA. She is a former Nurse. Before taking up a post in Ireland she set up a Staff counselling service in Bart’s and the Royal London Trust. She was awarded the MSc in Group Psychotherapy in 1996. Not working clinically currently she has taken up writing. Poems and occasional memoir pieces.
