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	Survivors of Sexual Abuse by Priests in Living Hell Alameda Times-Star [California] Downloaded May 6, 2004 IT consumed her entire life, the priest's hand on her body creating a permanent tattoo that penetrated deeply into her soul. She couldn't concentrate on her work, and her business regularly faltered. Her sleep fragmented routinely under the weight of her nightmares. Memories of being sexually abused by a revered member of the local clergy haunted her, and they formed barriers between her and the church doorway, between her and relationships with men. She developed headaches, muscle pains, stomach distress and chest pressure that defied repeated diagnostic divinations for physical causes. Well into her 40s, she felt that her life had been stolen from her decades earlier by the popular priest who repeatedly violated her young body. The woman who told me this story is but one of thousands of adults living with the trauma of childhood sexual abuse suffered at the hands of Catholic clergymen in the United States. Two studies reported in the Washington Post on February 26 indicated that this current epidemic of child sexual abuse has involved at least 4 percent of all Roman Catholic priests who, between 1950 and 2002, allegedly victimized 10,667 children. And although already alarming, these numbers are considered to be underestimates because they depended upon self-reporting by American bishops. Like many other victims of this pedophilia scandal, this woman bore her trauma in silence, unconsciously forcing her body to express the suffering she could not voice. The shroud of silence that characteristically drapes over this traumatic experience is a complex weave, but a central thread is the tendency of these victims to blame themselves. Victims often bear the stigma of shame, and they fear being rebuked and discredited if they dare to criticize priests for ungodly acts. The health care system often fails these victims as well. Despite multiple presentations to the medical establishment with undiagnosable conditions, this woman never divulged her history of abuse with a doctor. No health care professional had inquired about that possibility until a gynecologic nurse practitioner presented her with a standard questionnaire soliciting Information about prior sexual trauma. This deplorable pedophilia scandal should remind us all about the devastating long-term consequences of childhood sexual abuse in general. It should rouse in us a compassionate awareness about the myriad difficulties that its victims may experience. As the American College of Obstetrics and Gynecology points out, adults with histories of sexual abuse often manifest a host of psychological, behavioral, and physical symptoms. Physical complaints commonly include chronic pain syndromes, various gastrointestinal or musculoskeletal symptoms, sleep and eating disorders, and sexual dysfunction. Prevalent psychological and behavioral dysfunctions include depression, anxiety, sexual dysfunction, self-injury and dissociative states. In the medical setting, I would argue in favor of all patients being queried about any prior sexual abuse and trauma. If we limit our screening only to people with symptoms that defy medical diagnosis, we will miss a great number of opportunities to identify victims of abuse who might benefit from therapeutic interventions. In fact, a study published in 1993 in the Journal of the American Board of Family Practice revealed that, when proactively screened, about 40 percent of women in a primary care setting reported having experienced some form of childhood sexual contact, and 1 in 6 of those women had been raped as a child. Counseling and psychotherapy can prove to be a godsend for adult survivors of childhood sexual trauma according to Rosemary Ehat, a psychotherapist in Berkeley with an interest in the victims of sexual abuse by Catholic priests. She reports that such survivors typically feel shame, guilt, self-loathing, and depression. She says that "rather than realizing that the shame belongs to the perpetrator, the survivor feels bad and somehow tainted. Consequently, some wait 10, 20, or even 50 years before breaking the chains of silence that kept them locked in isolation." In addition to the physical and psychological expressions of their abuse, "these people also lose their religious and spiritual home" and "they go on with their lives but feel burdened by the secret and the feelings of betrayal and abandonment." She also suggests that a healing and supportive environment may be found through participation in support groups like SNAP (Survivors' Network of those Abused by Priests, Web site: www.survivorsnetwork.org The alarming magnitude of childhood sexual abuse by Catholic priests as revealed in the new studies and the known high prevalence of abuse within the general public recommend that we vigorously speak out against this appalling and widespread crime. That we lend our voices to the victims, to help them break the silence that insulates them from opportunities for healing. That as health care workers we assume a proactive stance in remaining mindful of the ways that their suffering can be expressed, physically and psychologically. As Ms. Ehat reminds us, "Lifting the veil of secrecy and cover-ups is the first step in bringing about both private and communal healing. Kate Scannell practices medicine with Kaiser Permanente and authored the book, "Death of the Good Doctor."
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