Dr. Cecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for us in many articles over the years. We asked her to discuss, this week, a possible path to psychological recovery for the three victims of the kidnappings in Central Ohio. —Ed.

4723657763_f85d0d2b36_zImage by Helga Weber via Flickr

After the horrific discovery last week of three women, kept in captivity by an Ohio man and finally freed after 9 to 11 years, we are all wondering how they will recover from such an ordeal. What are the scars from an experience of this kind, and will they be ameliorated by time and treatment, or can they never be erased? Though kidnapping cases of years-long, or even decades-long, duration are disturbingly more and more common, we still don’t know that much about the long-range effects of this suffering on the victims.

The women’s recovery will depend on several factors, the first being their prior level of and functioning, development, and age. One unusual aspect of the Cleveland case is that there were 3 victims in the same environment, but they were 14, 16, and 21 when they were abducted. While two of the girls appear to have been average and from stable, loving homes, the third victim, Michelle Knight, was described by a missing-persons report in 2002 as having a mental condition and being apt to be “easily confused” by her surroundings. It’s not surprising, then, that she was kept in the hospital for several days after her rescue and that little information has been released to the public about her current status. Sadly, it is quite likely that her (alleged) pre-existing mental condition makes her vulnerable to suffering more extreme lasting consequences.

On the other hand, the other two victims, Amanda Berry and Gina DeJesus, seemed to have been stable young girls, and they have been welcomed back into warm families and communities. Both of these factors bode well for their future. Continued support in their environment will be crucial in the months and years ahead.

However, there are significant hurdles for these women that all victims share. They must all be considered to be suffering from Post Traumatic Stress Disorder (PTSD), and should be treated as victims of domestic and sexual violence and abuse. Both conditions entail a wide range of symptoms—including, but not limited to, depression, anxiety, insomnia, night terrors, nightmares, flashbacks, loss of appetite, withdrawal, hyper-vigilance, suicidal ideation, and so on.

Therapy should begin immediately, and their reintroduction to “normal life” must be as gentle and slow as possible. These women need to be treated like war refugees. This war, however, was some 10 years of deadly daily battle in a completely isolated place where no one else in the world has ever been.

Victims of sexual abuse suffer universally from feelings of guilt and shame. No matter how horrified they are about having been raped, abused women (and men) feel somehow that they have “participated” in the scenario. The victim is usually left quite literally with a “residue” from the sex act (and in the case of one victim, Amanda Berry, a child), so the concrete, physical evidence of their shame is there as a reminder. The situation for the Cleveland women was compounded by the kidnapping.  As a result, they were subjected not only to the abuse for years on end, but also to the paramount factor of isolation. Isolating one’s victim is the No. 1 tool of the abuser. The abused woman can’t get away from her tormentor. Consequently, her ability to “test reality” and see the world through eyes other than his is lost. He treats her as if she is garbage, and so she becomes his garbage, and she has no barometer other than him.

In the weeks and months to come, we will no doubt learn more details of the experience that might predict how hard their recovery will be. There are some ways in which captors can go about destroying the ego, or sense of self, of their victims, that can be particularly devastating. For example, using techniques such as changing the girls’ names, or isolating them from each other, serves to further isolate them from any anchor that could help them withstand his assaults to their psychological cohesiveness. Ironically, motherhood may have given Amanda Berry an advantage. Having had her baby to form a bond with, she had the identity of motherhood to ground her and give her purpose (and love). On the other hand, if her captor threatened or abused the child, her stress level may have been even higher than her fellow victims’.

A trauma is an event that is too extreme, too foreign, or too violent for the psyche to comprehend. It takes a long time to perceive, metabolize, and ultimately understand. When you do, it becomes, for better or worse, a part of your history and your identity. Recently we have seen how much emotional pain both Sandy Hook and the Boston Marathon have caused on a national level as people have tried to comprehend events that are too horrible to imagine but that also change the way we think about ourselves and the world around us. Imagine 10 years of days like those and you have some idea of the challenge that lies ahead for these women. 

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