I need to do some thing about myself. I have known this for some time, but never realised until a few months ago that what I needed help with was being abused as a child. I am 43 this year and am shaking as I write this because this is the closest I have come to admitting it to myself and I am so afraid something terrible is going to happen. I really need to get some help, but don't know how to make that first step. It just seems too much to handle, but I have to do it because I think that it is affecting how I relate to my son. He is 11 years old and we are very close and very tactile, but sometimes now when he touches me I cringe inside and have to try very hard not to push him away. This started only a couple of months ago, but it's getting worse. It's just the two of us and I don't want to ruin him or our relationship. I know that I have to conquer this if I am going to be of any use to anybody. It's easy to say “get therapy”, but I just don't have the strength and courage to do it yet. Please can you tell me how I do this? I know I need to, but I just can't. Even to think about it makes me feel as if I'm going to explode inside and I'm remembering more every day that makes me feel I really don't want to open those doors. Please help me.

Judy

What you are experiencing is frightening, but what you have done, by acknowledging it, is courageous and the first step to getting through the memories and experience of being abused as a child. To normalise (not trivialise) what you are experiencing, it is important that you know that many adult survivors of child sexual abuse will have a resurgence of memories at different times as they raise their own children. I have worked with many mothers who suddenly become anxious and overly protective of their daughter when she reaches the age that they were when abused. Your son becoming older, hitting puberty and beginning to appear more male feels threatening to you.

You managed to show clarity in your conviction that this reaction is your issue and not his, and you know that you must address this so as not to cause him, or your relationship with him, problems. You recognise that your flinching and cringing towards him are projections of your own memories of being abused and not a reflection of how you feel about him. Despite how helpless you feel, you are being an incredible parent. I can't tell you the countless children who bear the scars (emotionally and sometimes physically) of their parents' own abusive experiences. I am not saying that all who are abused become abusers, but sometimes overwhelming emotional and psychological difficulties in adulthood that go back to childhood can, and are, taken out on the next generation. Your difficulties are a combination of recovering memories and acute anxiety. It is estimated that in about 40 per cent of women survivors of childhood abuse there will be a major depression and panic disorder. Post-traumatic stress disorder (PTSD) is even more common. For you, PTSD explains the recovering memories and flashbacks: experiences laid down in the part of the brain that stores emotional memories are triggered by your son's physical presence. The reason that they have been “buried” for so long and you have been “unaware” of them is because it is likely that as you were being abused, like many children in this situation, you dissociated from the experience (split your body from your mind) as a way of coping. Emotional memories will re-emerge when, and if, they are triggered, as is happening now.

There is also an overlay of anxiety - a profound anxiety response to being touched by your son and this is distinct from the PTSD memories. It sounds as if you physically recoil at his touch and experience real symptoms of anxiety: racing heart, increased breathing, sweating and muscle tension. These are the physiological changes that occur as part of the “fight/flight” response when we are confronted by a threat.

To help you to move forward, let's split up your experience in manageable chunks: dealing with the physical anxiety; dealing with the memories; feeling less alone. In terms of the physical anxiety, you are clear that your son is not your abuser, but that he triggers a fight/ flight response. Write down all your physical symptoms and look at how they are impacting on your behaviour and how they trigger panic. The key to managing this is relaxation therapy - the most useful and easy way is to learn progressive muscle relaxation, where you are taught to tense and relax all the muscle groups in your body. There are many CDs and books where you can pair feelings of relaxation with images of tranquillity.

As you learn the techniques, use them when you are hugging your son - relax your mind and body, call him over for a hug and during periods of increasing “cuddle time” show yourself how you are no longer anxious in physical contact with him because he is not the abuser. However, you will also need other support to understand the meaning and role of your anxiety. The treatments with the best outcomes are cognitive behaviour therapy - managing thoughts, feelings and behaviour underpinned by negative beliefs that usually come from difficult early-life experiences. And psychodynamic psychotherapy, which will help you to explore long-term sources of depression or anxiety that involve conflicts and early relationships and attachment problems.

An amalgamation of these two therapies is cognitive analytic therapy (CAT), a brief intervention of usually 16 sessions. It analyses thoughts, feelings and behaviour; unconscious factors are explored and worked with and their impact is recognised. The overall aim is to develop self-awareness and the development of tools for understanding and changing unhelpful coping procedures (see www.acat.me.uk).

But given that you are experiencing unprocessed memories in their “raw” form, it could be argued that the traumatic thoughts and feelings are “trapped” in the nervous system and need to be reprocessed. Eye movement desensitisation and reprocessing (EMDR) is a specialised form of psychotherapy that is used almost exclusively for treating PTSD. It stimulates rapid eye movement (using a guided light) while gently working through what is remembered of the traumatic event. The theory is that just as REM (dream) sleep works to process the day's events, eye movements during the EMDR session do the same for traumatic memories and help the brain to successfully process the experience without the person feeling a loss of control. The National Institute for Clinical Excellence recommends only cognitive therapy and EMDR for PTSD. For further information: emdrassociation.org.uk.

Finally, while I appreciate that you feel uncomfortable talking to others face-to-face at the moment, why not take advantage of the anonymity of the internet and seek support from those who know what you are going through. Check out Survivors and Friends (www.sandf.org).

You are a good mother who wants to keep her despair away from her son. You are a good mother who is making herself address the pain that she'd rather forget so that it won't pollute the bond with her son. You are a good woman who will survive and move on in a way that will amaze you. This experience will in time enable you to live life with courage, with confidence and with considerable pride in the wonderful young man that you have raised.

Work or family problems? E-mail: drtanyabyron@thetimes.co.uk

Write to her at: times2, 1 Pennington Street, London E98 1TT, include your name, age, address and telephone number.
Dr Byron cannot enter into personal correspondence

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