CCChat
November 2020
The FREE magazine on &
around coercive control
BAL HOWARD on
FORCED MARRIAGE
Dr Karen Williams on
Psychiatry, Borderline Personality
Disorders and Coercive Control
Contents
Editor's Notes
5 Min talks about the need to have
uncomfortable conversations, H.O.P.E. and
calendars.
The CCChat Interview
7 Bal Howard on escaping a forced marriage
and what it has taken to find healing.
The CCChat Interview
18 Dr Karen Williams on psychiatry,
borderline personality disorder and
coercive control.
More Than A Bruise
28 SODA founder Sam Billingham has a new
campaign that starts on 1st December.
Making The Invisible Visible
Editor's Notes
About The Editor
Min Grob started
Conference on Coercive
Control in June 2015,
following the end of a
relationship that was both
coercive and controlling.
Since then, there have been
several national
conferences as well as
smaller events.
Min’s interest lies in
recognising coercive control
in its initial stages, in
identifying the ‘red flags’ of
a potentially abusive
relationship before a person
becomes too invested in the
relationship, as that is when
it will be much more difficult
to leave, as well as the
challenges faced when
living with and recovering
from trauma.
Min has talked on
identifying covert abuse
and, with the use of
examples from social
media, she identifies a
number of covert tactics that
are commonly used to
manipulate. These tactics
will often be invisible in plain
sight- as the abuser seeks
to remain undetected.
Min is also a public speaker,
and speaks on both her
personal experience of
coercive control, family
courts and the livedexperience
of trauma - as
well as more generally of
abuse that is hidden in plain
sight.
Let's Grow The
Conversation!
To contact Min:
contact@
coercivecontrol.co.uk
Uncomfortable Conversations
Hello and welcome to this issue of CCChat Magazine.
This is a very special issue where I interview two hugely inspirational
women - Bal Howard and Dr Karen Williams - who are looking to change
the landscape around how abuse is understood. It is also special because
it features, on the cover, an image from the H.O.P.E. Digital Art Project,
which both celebrates and raises awareness of black, Asian and
minority ethnic women either working, advocating or campaigning within
the domestic abuse & sexual violence sector. H.O.P.E. stands for Helping
Other People Everyday and the project is the brainchild of Meena Kumari
of H.O.P.E. Training and Consultancy, which provides training &
consultancy in domestic abuse, sexual violence, sexual abuse and
safeguarding. Meena teamed up with artist and Psychology graduate,
Daisy Meredith for this project and the beautiful images are available as a
calendar. More information on Meena, her work, the H.O.P.E. Digital Art
Project and calendar can be found on www.hopetraining.co.uk.
Regular readers have noticed CCChat taking a new direction in terms of
content with more indepth interviews and this will continue as I focus not
only on a deeper understanding of coercive control, the myriad ways it
manifests, not only in an intimate or family context, but also what it looks
like in a wider setting - for example, what it looks like in the professional
world, in government, in politics and elsewhere in society. As part of that, I
will also be further exploring the barriers to identifying and addressing
coercive control, namely the myths and biases that can skew perceptions.
It's time we looked at the bigger picture - the macrocosm of control. It's
time to delve deeper and have the uncomfortable conversations that will
propel us towards a much deeper understanding of the dynamics involved.
Min x
Making The Invisible Visible
The CCChat
Interview
Bal Howard
Making The Invisible Visible
The CCChat Interview
Bal Kaur Howard
Bal Kaur Howard has been
advocating on the issues of
Black and Minority Ethnic
women and men on
domestic violence, honour
based crimes (Forced
Marriage & Female Genital
Mutilation) and Child
Sexual Exploitation (CSE)
since 2008.
Born in India and brought
to Britain aged one, Bal
was forced into marriage at
the age of 17
She went back to education
at the age of 26 after
escaping and has
subsequently been
disowned by her family for
over 20 years.
Employed by Suffolk
Constabulary for 7½ years,
Bal was responsible for
developing policies,
procedures and training for
police officers and partner
agencies to enhance the
service to victims and
potential victims.
Since leaving the police,
Bal has developed and now
delivers training for frontline
practitioners
throughout England and
Wales.
Her website is:
www.bkhtraining.co.uk
B
al Howard has an award-winning company
providing seminars, training courses and
workshops for professionals whose work
includes cases of domestic abuse and
exploitation by individuals or criminal
gangs. I asked her about her decision to go
into this area.
B: I started out in the public sector, my back ground is in
sales and marketing in the corporate world and then Banaz
Mahmod was murdered by her father, her uncle and three
members of their community. At that time, I had also read
Jasvinder Sanghera’s book, SHAME and realised that that
was my story, so I emailed the author, not for one minute
thinking that she would email me back, but she did.
Around that time, Jasvinder was going round the country
raising awareness with the Forced Marriage Unit that had
just been formed and she asked if I would like to join her
and I said I’d love to. So I went around the country and
there was an event in Duxford, and, on the way back, I was
at Cambridge railway station and both the Superintendent
from the police and the Domestic Abuse Manager were
there. They were thinking about creating a job and we
talked about what it should look like, what the role would
entail.
When the job was advertised, I applied and got it. I didn't
have much to put in the application form, apart from my
own experience, and so I put it down and got the job.
I was with the constabulary for seven and a half years. The
Honour Based Violence strategy was formed at the end of
2008 and in that were 90 recommendations and all police
forces signed those 90 recommendations. We needed to
educate other professionals, partner agencies around
forced marriage, honour based violence and FGM, so when
I went into the police, the first thing I did jointly with
Suffolk County Council, was form a Steering Group with
various different agencies on how we were going to take
this forward in terms of training and the role evolved from
there. There wasn't a single case of Honour Based Violence,
Forced Marriage or Female Genital Mutilation (FGM) at
that time.We then started to see between thirty to fifty
cases a year.
Making The Invisible Visible
" I witnessed, as a child, fights with baseball bats, bricks,
windows crashing in, dinners going on the wall and
I didn't really want to be part of that family."
Bal Howard
M: It was obviously needed.
B: Yes, and I think it’s still needed now. I
loved the frontline victim work. Putting
the policies and practices in place was
really good as well, as it was a nice
learning curve putting together a police
policy for how to handle these cases and
then doing the joint Honour Based
Violence, Forced Marriage and FGM
policies for Suffolk County Council and
Children and Adults Safeguarding.
The Home Office guidance was released
around that time and so I started using
my own story to change hearts and minds
during training sessions.
I would say that even if you forget the
training, you never forget the story.
M: Bal, for the readers who haven’t heard
your story, are you happy to share it?
B: Yes, I share to educate, so I have no
problem with talking about it. I was born
in India. I was just one year old when my
parents relocated to the UK. They came
because of the migration that was
happening at the time, because there
weren’t sufficient people in the labour
market. They had no intention of staying
as such, but that’s what happened.
I wish my dad had left his core beliefs and
values behind him, at Heathrow Airport,
but he just didn’t. He brought them in
with him. So we settled in the North East
of England and in that family
environment, there was my dad’s brother
and his family, my mum’s brother and his
family, and we all lived together.
Making The Invisible Visible
Then when I was nine, we came back to
the UK. I didn’t speak any English, was
put in a really low class and then two
years later, I went into secondary
education where I was also put in a really
low class, where I was second from
bottom. When I hit puberty at the age of
thirteen, my dad removed me from school
and I just didn’t go back.
M: Could he just do that?
B: At the time yes and nobody, none of
the teachers came looking for me.
M: Oh wow.
I lived with domestic abuse from the
different family members. I witnessed, as
a child, fights with baseball bats, bricks,
windows crashing in, dinners going on
the wall and I didn't really want to be part
of that family but then at school, I was
one of four Asian kids in the whole
school, so I was bullied because of my
skin colour but, actually, school was
better than home.
I wished school was from 9 o’clock in the
morning to 9 o’clock at night and with no
school holidays. I used to think that I
don’t belong to this family and when I
was seven, my dad relocated back to
India, so we all moved back.
We lived out there for two years and those
were the happiest memories of my
childhood. Dad wasn’t around and we
were free, as children, to go and do what
we wanted.
Dad had tried to protect us from getting
too westernised so we weren’t allowed to
have English friends over, we weren’t
allowed to go to their houses so, it was a
very controlled environment.
B: I just stayed at home and was being
taught how to cook, clean, how to look
after the other children in the household.
My dad said I won’t need an education. I
knew I was going to have an arranged
marriage, but I didn’t think it would be
forced and then at 17, my dad and uncle
drove me to Yorkshire, where I met the
man who was going to be my husband. I
was 17, he was 25.
I wasn’t allowed to be alone with him or
anything and, on the way back, my dad
said what did I think? I said 'No' and my
dad said that’s the man you’re going to
marry whether you like it or not. If you’re
thinking of running away, I’ll find you, I’ll
kill you and I’ll go to prison. And I totally
believed he would do that.
I’ve had cousins who had fled and they’d
found them through a telephone
number,or they’d camp outside people’s
houses to find them so I just thought,
where would I go? Where am I going to
live? They’d find me anyway so I went
through the marriage when I was 17.
M: The level of fear you must have felt
must have been sky high.
B: It was massive. My mum said it was
my duty as a daughter not to bring shame
on the family. You will do whatever it
takes to remain in that household
Making The Invisible Visible
and we don’t want to hear anything bad.
Anything, like she doesn’t cook, she
doesn’t clean. Anything bad.
So I went off with a strange family. I
didn’t even know who they were. That
night I was raped by my husband. I didn’t
even know what sex was at that time but
that daily rape happened for almost 8 and
a half years of my life.
I wasn’t coping. I’d be going back home
saying I didn’t want to be in the marriage,
and I’d get sent back to him. It was
control from the in-laws and extended inlaws,
it wasn’t just one person, it was all
of them. I was jumpy, on edge all the
time, making sure I did everything right. I
was so underweight it was unbelievable.
They would get this brown powder from
India and they said this will help you fall
pregnant, drink it. There was this one
Auntie who told me to pretend to drink it,
don’t drink it because you don’t know
what’s in it.
M: I was going to ask what’s in it.
B: Yeah. I think I drank it a couple of
times in front of them, then they left me
to it and I’d pretend I was drinking it. I
was pregnant three times and miscarried
three times. Nobody asked any questions
and on the third miscarriage I thought I
needed to get out and so I made a
decision. It took three months of planning
to destroy everything with my name on it.
" I would say that even if you forget the training,
you never forget the story."
Bal Howard
I went to the family GP when I was 18 and
said I wasn’t coping very well. I couldn’t
tell him what was going on as I knew it
would get back. But he gave me valium
and I absolutely loved the valium. It fixed
a pain on the inside.
I then think I went shopping. I’d not told
anybody but they had found out where I’d
parked the car and were waiting around
the car for me. They invited my family
from the North and I had lectures from
them. I can’t even remember the number
of hours. I just remember focusing on the
carpet, counting the squares so I wouldn’t
pass out and that night I took the lot. All
of the valium. I didn’t want to be alive.
Obviously God had a different plan.
I then thought how am I going to get
through this alive? So I thought I’d have
children. I’d have somebody to love and
somebody to love me back. He was an
only son so it was expected.
I destroyed everything, my National
Insurance number, NHS number because
those were the things that could be used
to track people.
I then went into a police station and said
to the police that I’m going of my own
free will but my family are going to report
me missing.
I fled on the 28th of March 1996. I had
chosen London as I thought they wouldn’t
find me there and then my new life
started.
I knew that as a result of me leaving, I
wouldn’t see any of my family ever again
and I’ve not seen them for over 24 years.
The shame and dishonour. They moved
from the North East to Bedfordshire
where they built this new family
community.
Making The Invisible Visible
My little sister needed safe guarding. She
had a learning disability and was about 8
or 10 years old but they had already
arranged her marriage. I knew the person
they were going to marry her to, so I rang
the police, and told them that my sister is
at risk and they would have to track her
wherever she goes.
There were three missing persons reports
for me, from various different family
members and there were posters and
leaftlets in all of the houses nearby,
asking if anyone had seen anything, then
they got a private detective to find me as
well – which I didn’t find out until years
later.
I then did some training in Bedfordshire
where three professionals came up to me
asking if I had a little sister who lives in
Bedford. They said my mannerisms were
just like my little sister, that I was just like
her. I then found out that my mum had
passed away and that my dad was a really
nice man, that my sister was in assisted
accommodated living as dad couldn’t
cope but she goes home at weekends and
I just thought to myself, it’s really
interesting.
I had to leave the training room, went to
the toilet and composed myself, did my
meditation. I then went back and
delivered the Honour Based Violence and
Forced Marriage training and right at the
end I shared my story with photographs.
" There were three missing persons reports for me, from various different family
members and there were posters and leaftlets in all of the houses nearby, asking if
anyone had seen anything."
Bal Howard
The officer I’d asked to safeguard my little
sister rang me back three times and I
never forgot her name. It was the first
time I had sought external help and she
had helped me.
When we did the DA Matters training in
Suffolk in 2016, I was sent to Bristol on
'Train the Trainer' with Safelives. I was
sitting there, a whole load of us, and we
had to introduce ourselves and the two
trainers introduced themselves and one of
them was this officer.
M: No way!
B: Yes, after 18 years. It was 2016, I
couldn’t believe it. It was just incredible.
So my sister is safeguarded to this day,
which is incredible.
Then I looked at these three professionals
and then I said "My dad’s a really nice
man."
M: Oh my God, did they squirm?
B: I just left them to it, though I did ask if
there were any photos of me in the house,
has he ever mentioned that he’s got this
oldest child that happens to be me?
Never mentioned it to the professionals.
M: Oh my God. That must have really
made them think- especially as they had
thought he was such a nice man.
B: Then I got to Hitchin railway station
and that’s when I burst into tears.
M: I can't believe you lasted that long.
B: Yeah. I lasted that long. That was a
powerful session.
Making The Invisible Visible
What that led to was me being contacted
by a social worker who had engaged with
my little sister but, because she goes
home at weekends, I didn’t want to put
her through emotional turmoil, so I
worked with social services to ask her a
few questions. She remembers me and
talks about me and she carries a photo of
my mum around with her.
Maybe one day I’ll get to see her but right
now is not the right time. So, at least
that’s there. When my Dad dies, I’ll get to
see her again. But it’s been an awfully
long time. March next year it will be
twenty five years. A quarter of a century.
When you walk away, it’s not walking
away from one perpetrator, it’s walking
away from them all.
The relationship, the whole way through,
felt uncomfortable but then I thought this
is how relationships are meant to be. He
introduced me to cocaine. I just loved that
lifestyle of going out but it felt really
uncomfortable, so I decided to do
another geographical and moved to
Oxford, then Cambridge, then Corby.
I kept moving, not making any Asian
friends, so I wouldn’t be linked back. I
literally just moved around the country
to different locations with different jobs
and then I thought, that’s it, I don’t want
to be in a relationship ever again until I
met my husband, in Ipswich. It took two
years and two months to go on a date
with him. We got married and have been
married for fifteen years.
" I tried to find a therapist. I was grieving
but my family were all still alive."
Bal Howard
I tried to find a therapist. I was grieving
but my family were all still alive, so it was
really difficult to find one who
understood. I couldn’t find one until
towards 2012. It was someone who works
with war veterans and he kind of started
my journey into therapy. He’s a Human
Givens therapist, which isn’t talking
therapy. Talking therapy was stressing me
out. This was more hypnotherapy and
something started shifting.
I had gone back to studying when I was
26. I went to the University of Greenwich
and did a couple of diplomas and met a
man. He was eleven and a half years older
than me. I had never had a drink, had
never gone to the pub. I went to the pub
for the first time. This guy wined and
dined me and bought all my clothes and
jewellery. Looking back, reflecting on it, it
was just coercive control.
The shit really hit the fan after that. I felt
safe for the first time in my life but
emotionally I wasn’t coping. I was
working for the police, and on a
concoction of a lot of prescription
medication , Diazepam,Temazepam,
Gabapentin, Propanalol, 220 mg of anti
depressants. I was trying to cope but not
really coping and so I started using
cocaine in the morning and then alcohol
in the evening- along with all these
prescription pills- and slowly fell into
addiction.
I have to say, hands on my heart, with
everything I have been through, this was
the hardest thing I’ve ever done. I just
could not believe how much power this
addiction had and I was becoming an
abuser. I was becoming very aggressive
towards my husband and I was delivering
domestic abuse training thinking yeah, I
do that, and I do that.
Making The Invisible Visible
So it became a revolving door for six years
with mental health services and
addiction. It broke me. It brought me to
my knees. It was a kind of another
spiritual awakening, I needed help so I
went to rehab.
I’d heard of East Coast Recovery because
I’d worked with a victim in there and I
thought, I need that service so I made a
phone call at 8.30 in the morning on 3rd
January 2013 and that day this guy, who’s
a good friend of mine still, he lived in
Somerleyton, he worked in Lowestoft and
he said, Bal I’m actually 1.1 miles away
from your house, I could come and pick
you up and I said yes please.
I didn’t want to be like my dad. My dad’s
last words were you’ll end up in the
gutter. If I get drugs tested at work it will
be instant dismissal and the home is
going to go, the marriage is going to go
but I just couldn’t, on sheer will power
alone, I couldn’t beat that thing, so in
January 2013, I ended up in residential
rehab in Lowestoft for three months.
So I went into rehab and they asked me
how long am I here for and I said I’m here
for as long as it takes, so I went and
stayed there. That’s when I learnt to live,
at the age of forty three..
I learnt what it really meant. Rehab saved
my life and taught me how I was going to
live on a daily basis.
" I knew I was going to have an arranged marriage,
but I didn’t think it would be forced."
Bal Howard
I went in on January 3rd. I struggled with
mental health services around that time,
because they wouldn’t assess me. They
wouldn’t make an assessment when I was
off my face, because I was intoxicated and
that’s when I desperately needed it more
than anything else, but when I presented,
I presented really well, I mean I hid it
from work so when I presented at work,
to mental health services, they said you
don’t fit the category, you’re fine. There's
nothing wrong with you.
My spiritual journey started there
because the first thing we did, every day
for three months, from nine o’clock until
half nine was meditation. We did positive
affirmations, prayers, if we wanted to,
and now mediation is now 70% of my
recovery. I did Alcoholics Anonymous
meetings, Cocaine Anonymous, Narcotics
Anonymous but rehab gave me, in the
three months I had probably 400 hours of
therapy. 1-2-1 therapy, group therapy,
acupuncture – they did the whole holistic
thing and it was just an incredible
journey. Lowestoft was where I was
reborn.
Making The Invisible Visible
I hated going to Lowestoft before that.
And then my recovery journey took me
back to India. I met an Indian Catholic
Jesuit priest, who was also an atheist, at
Clare Priory, in Suffolk. He comes over to
the UK once a year. He said come to
India, so I went and for three days I cried,
so the broken parts of me were healed out
there. I spent 3 months with the Father
and talked about how I was born a Sikh,
Islam draws me but I go down the
Buddhist Centre as well, and he said to
me, don’t worry about that, these are just
different rivers to the same sea. Don’t
worry about religions.
M: That’s a really beautiful way of putting
it.
So I left rehab on the 28th of March 2013.
It was a Thursday and I fled on 28th
March 1996, which was also a Thursday
but this time I left with a brand new
family - the people I spent three months
with. I’ve been clean and sober since.
They detoxed me of all my prescription
medication as well and the only things I
take these days are ibuprofen or
paracetamol. My day starts with
gratitude. Father said to me that when I
wake up, my first morning thought, when
I regain consciousness, is to thank God
for another day. I shouldn’t be alive. I
should have been dead at 18. Dead by my
family, or during that marriage, or
because of the alcohol and drugs. For
years now, my first awakening thought:
Thank you God, for another day.
" Don’t worry about that,
these are just different rivers to the same sea."
B: Yes, so I go back to India every year,
apart from this year, since 2015 to the
Ashram for spiritual growth, yoga. We get
up at four in the morning to do Yoga,
stretches, meditation. He has really
enhanced my spiritual journey and if I get
stuck along the way, I just email him.
The other man who has been an amazing
inspiration in my life is Nazir Afzal who
was the Crown Prosecution lead for the
Rochdale Child sexual exploitation case. I
met him in 2008 and I said I can’t believe
a man is talking about violence against
women and girls and he’s actually an
Asian man. I sat with him in Manchester
in 2016 thinking about leaving the police
and I asked him if he would be my
mentor. He kind of helped me and guided
me, which is incredible but he also did
little things like text me on Diwali,
because no one sends me birthday cards
or Diwali cards so that is really special.
I feel whole again. Without rehab
teaching me how to live, I only thought I
was, but I know that I wasn’t. The
relationship at home needed a lot of
healing as the marriage would have ended
because of my behaviours and we had ten
months of therapy with an addiction
counsellor, to save my marriage and
also,at the same time, my husband
needed to understand addiction.
M: I’ve been spending the last few
months better understanding trauma and
have been reading a lot about Gabor
Mate’s work and how addiction comes
from some form of trauma.
B: Yes, it completely does and that is how
my courses came about – from my own
experiences. I then started delivering on
Modern Slavery and Trafficking,
Extremism and Radicalisation. I won’t
deliver anything that I don’t feel
passionate about.
Making The Invisible Visible
Training Offered By Bal Howard:
Toxic Trio – Exploring domestic abuse,
substance misuse and mental health
Domestic Abuse – Half Day or Full Day
(Depending on the Objectives)
Harmful Practices / Hidden Harm
Honour Based Abuse Forced Marriage
Female Genital Mutilation (FGM)
Breast Flattening / Ironing
Child Criminal Exploitation (CCE) /
Child Sexual Exploitation (CSE)
Extremism and Radicalisation
Modern Slavery / Trafficking Addiction
Drug Awareness & Reducing Harm
NPS (Psychoactive Substances)
Emerging Trends & Challenges
Young People, Families & Drug Use
Introduction to Motivational
Interviewing
To find out more about Bal Howard and
her training courses, please go to
http://bkhtraining.co.uk
Making The Invisible Visible
CCChat Interview
Dr Karen Williams
Trauma Specialist
Making The Invisible Visible
CCChat Interview
Dr Karen Williams
Dr Karen Williams is an Australian consultant psychiatrist specialising in Post
Traumatic Stress Disorder. She is the founder of Doctors Against Violence
Towards Women - an advocacy group promoting mental and physical safety of
women who are survivors of family violence and sexual assault.
M: Thank you so much for agreeing to be
interviewed. You are the first psychiatrist
I have interviewed and I am really looking
forward to learning more from you, but
first, what made you decide to go into
psychiatry?
K: I went into medicine with the idea that
I was going to be a paediatrician. At the
time I, like many other people, wanted to
go into general medicine. I didn’t think
about mental health at all, I think most
people don’t. You think of physical health,
so I had gone into it that way.
I then heard that with psychiatry you
start at nine o’clock and you get to have
coffee, so that was the appealing thing to
me. I’d love to say it was for a benevolent
reason but I wanted to do a three- month
term, so that I would be able to rest after
the really long vascular terms.
Surgical terms start at six and go on until
eleven, so I thought I was going to get a
break! I really didn’t know that much as
we hadn't really done much mental health
training.
What ended up happening was that one of
the first patients I saw, with a male
psychiatrist, was a young woman. She had
cut herself and taken an overdose. He
took maybe five minutes and then said
she had borderline personality disorder.
Now this was all very foreign to me, what
was this? How did he make that decision
when he had only talked to her for a few
minutes? I asked him but he really just
fobbed me off with his explanation of how
he got that diagnosis.
Later on I went into an interview with the
patient. I wanted to talk to her in a little
bit more detail. This was just me going off
my own back, going away and having a
chat to her. I asked her why did you do
this and she said to me that her husband
had done all these things to her. I asked
her questions about her background and
we went through her life story and it was
a story of just awful abuse.
I went back to the consultant and said she
got bashed up just before she took the
overdose and he was like yeah, right,
that’s irrelevant. That’s not anything to do
with her presentation.
Making The Invisible Visible
In psychiatry we have a checkbox of
symptoms – do you have poor sleep? do
you eat? do you have lack of energy? do
you feel sad? Yes, yes, yes ,yes, so
you’re depressed. We have this way of
looking at the final symptoms and
deciding what the person is, based on that
final set of symptoms, not on any of the
things that led them to get there.
M: Oh my God.
K: And he goes, you’ll just know. We get a
lot of people from lower socio-economic
backgrounds round here.
That’s just part and parcel, a lot of
patients have that in their background,
it’s not part of the presentation.
That struck me as really quite odd but
then I started reading some of the
research papers on how, if a person had
undergone traumas in their childhood, it
causes physical damage to the brain and
that you can see it on scans, see the
neuro-chemical changes, the
hippocampal changes, you can actually
see that an assault has a physical impact
on the brain.
I was really excited by this and thought it
was going to be a game-changer, it would
change everything because people who
were telling me they had a history of
childhood abuse, sexual abuse, domestic
violence, all the people we had been
labelling as having mental illness were
actually traumatised. But it actually didn’t
change anything at all.
" We have this way of looking at the final symptoms and deciding
what the person is, based on that final set of symptoms,
not on any of the things that led them to get there."
Dr Karen Williams
For someone who had had no mental
health training, I was really shocked. I
thought that he must know stuff that I
don’t know. You kind of accept that this
older wiser man knows much more than
you do, so I figured that he must be right.
That was my first entry point into
psychiatry and over time, more and more,
I thought this was ridiculous.
How can none of this matter? These are
people’s lives and we are just looking at
the sum total of the person at the end?
A lot of people will forget their trauma,
so, if you’ve been assaulted and your
body’s way of dealing with it is to forget,
when a person asks you if you were
abused, you say no and you’re not lying
because you genuinely forgot, or you were
too little to remember.
Kids who have been raped at the age of
two don’t remember, so they might say
no,they weren't sexually abused because
they don’t remember or their body has
helped them to forget by closing off that
memory.We know that happens.
Making The Invisible Visible
" If a woman is being bashed or raped, we never say it’s PTSD,
we say she has got Borderline Personality Disorder.
Even though the symptoms are actually the same."
Dr Karen Williams
Or they don’t identify it, or they don’t
trust you and don’t want to tell you. They
don’t have to tell a researcher everything
about themselves, and as we know with
coercive control, the vast majority of
people won’t identify it.
If you take a man who has gone to war,
even if they have never been deployed,
they’ve joined the Navy and then they
show any signs of mental health – they
are aggressive, get angry, drink, get
depressed, agitated, with any of those
things, we immediately say they’ve got
PTSD but if a woman is being bashed or
raped, we never say it’s PTSD, we say she
has got borderline personality disorder.
Even though the symptoms are actually
the same.
I then found out there was a psychiatrist
in America, Bessel van der Kolk, who said
that all of these things that are happening
to people absolutely impacts the way that
they behave and what we are looking at is
traumatised individuals.
Over the years, I have done more and
more research into this as it’s become an
area of interest that I have devoted my
career to.
The female psychiatrists back in the
1960’s or 1970’s fought against getting
borderline personality disorder included
in the DSM, as they knew it was going to
be bad for women, and they were right. It
pretty much replaced hysteria and
the women who were diagnosed, were
probably just women who wanted to
stand up for themselves.
Making The Invisible Visible
So if someone is asking you, you do
sometimes feel angry? And you’ve been
raped and you say yes, the last thing you
think is that that person is going to do
something bad to you. You think that
person is going to help you. You answer
yes, yes, all very eager to get an answer to
your problem.
Women aren’t even necessarily realising
how horrible it is, to be sitting there and
for this psychiatrist to decide what they
have, because when they are then given
this diagnosis,and they need to try and
get custody of their child, they now have a
history of mental illness and a diagnosis,
so it makes it even harder for them to get
custody of their kids.
They were defined as hysterical and then
that term was taken out and essentially
replaced with borderline personality
disorder.
If you look at the shopping list of
symptoms for borderline personality
disorder, they include things like: is
impulsive, gets angry, rage, feels empty,
has mood swings. It doesn’t matter what
happened to that person, if at that
moment, if the moment you presented to
the doctor or psychiatrist and they ask, do
you have intense relationships, do you
have feelings of wanting to kill yourself,
and they’ve just had an overdose so I can
tick they’ve got suicidal thoughts, do you
get angry sometimes, yes, ok, you’ve got
all of those things, you’ve got borderline
personality disorder.
M: I'm really shocked by that. I had no
idea it was such a tick-box exercise.
K: Remembering that, at that point
people are very vulnerable. You go to a
psychiatrist because you’re vulnerable
and you’re worried about something,
something’s going wrong, and so you go
in, seeking answers.
What we’re seeing is there are
women who are losing custody to abusive
men because a doctor has given a
diagnosis of personality disorder or other
mental illness, when actually, when you
actually talk to them, they’re really
traumatised. This is why I’m such a
passionate advocate.
I work in a hospital, where I’m really
uniquely placed because I have the
defence force, the police and all other first
responders who I treat for PTSD and
that’s all funded by the defence force, the
government really. What I treat them
with is individual therapy, group therapy,
exercise therapy – they get relaxation,
mindfulness. We give them everything
that we can possibly give, to treat them.
That’s one part of my role and then I’ve
got an outpatient clinic where people can
come pay to see me. The women who
come to see me come with a referral from
their GP – this person has got depression,
anxiety, BPD anything. And almost every
single one, it’s very rare that I won’t have
a case where there is a history of abuse
somewhere.
M: That is absolutely staggering.
K: Yes, it is staggering.
Making The Invisible Visible
K: People will say to me, you’ve got all
these traumatised patients because you
are a trauma specialist but most of the
referrals do not say please see this person
for trauma, please see this person for the
rape that they experienced when they
were three, they say please see this person
for depression. They are the same
referrals that every psychiatrist in the
profession gets. It’s not different but what
is different is that I will spend 45 minutes
to an hour in talking to the patient.
Unfortunately, even if I say that’s what
I’m noticing, it will get dismissed, so I say
I’m happy for you to look at my referrals.
Have a look and tell me which ones say
domestic violence, sexual assault…. You
can count them, probably, on two hands.
We don’t compensate adequately for
someone who wants to do this history and
it’s the same in the general practice
setting as well.
Female practice GPs are getting all the
mental health cases, the domestic abuse
cases, as they are preferentially selected
by the women patients, for obvious
reasons.
Men are getting the coughs and colds
appointments and the women GP's are
getting far more complex cases as the
women are picking them and so there is a
gender gap there but not because women
are paid less than men but because they
get the cases that take longer.
" They are the same referrals that every psychiatrist in the profession gets.
It’s not different, only that I will spend
45 minutes to an hour in talking to the patient"
Dr Karen Williams
Most of the women will come with
histories where they've tried several
different anti depressants, and nothing is
helping them feel better, so they ask what
can they do about it? What do they do
next?
Then you listen and find out about their
family life, you find out about their past
and find that they’re either experiencing
abuse now or they’ve experienced it in the
past, always. Also not forgetting that if
someone can afford to see me, they are
not the worst off in society.
If you want to spend time with someone,
you are financially penalised because you
can’t charge the same as someone who
doesn’t spend as much time. There’s no
financial incentive to spend that time – to
invest in getting a proper history – it’s a
huge systems issue.
I can give you a fantastic example of
coercive control involving money. So this
woman was doing an anxiety course at
the hospital . She was on $150, 000 a
year, so really good income and she gives
all of her money to her partner who is on
$120,000 so he’s on a good income too,
but less than her, and all the money goes
to him.
She came into the office one day,
distraught, saying 'I destroy everything
that’s good in my life, I sabotage my
family'. She was so upset. She had gone
down to the shops and spent all this
money and was really upset that she had
done that. Taking money out of the kids’
livelihoods.
I asked what she spent the money on.
It was a journal.
A $14.00 journal.
Making The Invisible Visible
The psychology group she was in had told
her to buy a journal to write down her
feelings.This highly intelligent woman on
$150,000 was distraught that she was
ruining her children’s lives because she
had bought a journal.
What had happened was that her
husband had been tracking the card and
had immediately called her when she
bought it and said what the fuck are you
doing spending that money? We have
hardly any money and you are spending
it, what’s wrong with you, what’s WRONG
with you? She felt so terrible.
So I asked her how much do you think
you guys spend on bills, why would that
$14 make a difference?
And if you get a kid who has been under
the influence of a parent who has done
this and said this is how much money you
get, and you’re straight into marriage, it’s
very easy for a person to have no idea of
what the costs are. So it’s not that she’s
stupid, it was that she trusted and
believed that he would know and that he
was so angry at her that he must be right,
she must be spending too much.
So I asked, when did you last have a haircut?
I haven’t had a haircut in five years.
When was the last time you brought
yourself any new clothes? I haven’t, not
for several years. She believed that there
was no money and that is the perfect
example of coercive control.
" If you want to spend time with someone, you are financially penalised
because you can’t charge the same as someone who doesn’t spend
as much time. There’s no financial incentive to spend that time
– to invest in getting a proper history – it’s a huge systems issue."
Dr Karen Williams
I told her you guys are right up there,
amongst the wealthiest in our society,
earning around a quarter of a million a
year, why would you guys be struggling? I
don’t know, he’s the one who is managing
the money. How many houses do you
have? We have one How many mortgages
do you have? we have one mortgage.
M: What was he doing with the money?
K: He was keeping it from her. Whatever
it is, she had no access to it, she had no
idea. All he kept doing was saying there
was no money.
It’s not like she’s looking at the bank
accounts and saying there is nothing –
she is just relying on what he is telling
her. And he has just convinced her that by
the time he has paid off the electricity and
water and rates and all of this, there’s
nothing left and she believed it. That’s the
thing – she believed it.
You know, you can just convince
somebody that they are awful. You take
away their autonomy and you make out
they’re dumb and can’t manage and are
causing chaos for the family and ruining
everything and then, of course she feels
anxious and depressed because she’s
ruining her family. And so you come to a
psychiatric unit and hope they will help
you and you are given an anti depressant
and that reinforces the ideas that you are
mentally unstable.
M: Yeah, and you end up believing you’re
the problem and not the abuse.
K: Exactly. So this is where we, as a
society, continue to abuse this woman on
top of the man abusing her. So he will
abuse her then we will, by telling her she’s
mentally ill, she’s the one with the
problem and that she needs these
medications so that everything will get
better and so then what happens is that
Making The Invisible Visible
M: How do you self-care with all of that?
Because it must be so hard not to be
affected by it.
K: I think what’s happened for me has
been the advocacy thing, like, if I can
change things and make things different,
I feel like that’s my self care, that I’m
absolutely making a difference to people’s
lives and then my life is worthwhile and I
feel less helpless, because I think that why
you need self-care, is because you feel
helpless and hopeless.
M: That makes sense. I've never thought
of it like that.
she will go back to him and, if there’s
anything she argues about, he’ll say have
you taken your meds today? You clearly
haven’t taken your meds. It gets used
against her. Her opinions on everything
will be that’s because your mentally ill. It
happens all of the time.
That’s why when I see the women I say
I’m not giving you any meds and
sometimes they’re desperate. What’s
easier, if you have to think about it, is it
better to believe your husband who says
you’re nuts, go and see this doctor, go and
get some pills and feel better, is that
easier? Or is it better to hear from a
woman you don’t know, don’t trust that
you don’t need these pills. Which of these
things do you think they would prefer to
hear?
A lot of the time they would not come
back if I tell them that they are the ones
that are in the right and it is their
husbands that are the problem, so I have
to be so careful about the way I phrase
things and not push patients away by
being overzealous and, often, my
instinctive reaction would be to tell to
run.
K: If I can feel like I’m not helpless
because I am doing something with my
experience, I’m not sitting on it but trying
to make it mean something and I guess,
on some level, it gives me that bit of self
care. These little girls, especially, will
have this behaviour with other men
because they’re used to it. They’re used to
the man who has control, who is
aggressive and tells them what to do,
they’ve experienced nothing different so
they get into these relationships and
marriages where they’re not surprised if a
man controls them, they don’t know
anything less.
M: Yes, it’s all they know. To be
compliant, not rock the boat. It’s woven
into the fabric of who they are.
K: So when you are like that, you are
functioning on your primitive brain. It’s
the bit that’s in panic mode. You’re in
absolute panic mode so you won't sleep
properly and then you’d be sleep
deprived.
You can’t assess someone like that, it’s
like saying I’m going to hold a gun to your
head and then I’m going to get you to do
the crossword. You cannot do a crossword
when there is a kidnapper with a gun in
their hand.
Making The Invisible Visible
K: In Australia, what's happening in
court, is that no one can question the
decision that’s been made because you
can’t question the report. There are a final
set of recommendations and they’re
private, so the mum can’t go I want to see
the results of this, I want to know why
they made this determination.
There’s no way of doing that. You can’t
sue them, you can’t do anything. They are
completely safeguarded and so are the
magistrates. It needs to change.
Things need to be transparent, you need
to be able to see.
That’s what domestic violence is , so
there’s a kind of a clear picture of what
you have to have happened to you to be
truly a victim of domestic violence and
that means that everyone else who’s got
all these other things looks at themselves
and they don’t see themselves there.
That’s a huge problem because it’s
incredibly invalidating If you can’t see
yourself in the world around you. You
think there’s something wrong with you
so you buy right into the idea your
partner is selling you that there IS
something wrong with you and, if we
don’t teach women what coercive control
looks like, it’s going to be next to
impossible to heal properly.
" You cannot do a crossword when there is a kidnapper
with a gun in their hand."
M: What steps do you think a person who
has been gaslighted and controlled, can
do for their recovery, after they have left
the relationship?
K: The biggest thing is identification. Our
society has hidden that as an issue.
People are talking about coercive control
now but the vast majority of women girls,
teenagers, kids still don’t know what it is
and so they’re not seeing it in their
everyday lives. So not only are they
invisible in their homes, they are invisible
in the world around them.
They can’t identify themselves in the
world around them when, if they see
advertisements for family violence it’s
usually a shadow of a man with a closed
fist about to punch the woman who is
crouched down.
I know that what makes the biggest
difference to my patients is validation. Me
explaining to them that that behaviour is
not ok, do you see what he’s done to you?
And when they finally see it for what it is,
they can forgive themselves. Self
-forgiveness is one of the biggest things
because they hate themselves.
When you’re at that point of self
loathing,you know, I’m a horrible person,
I’m all these horrible things that he’s told
me I am - they absolutely believe that, so
when you can help them see that they are
not the horrible one, they are not bad or
shameful or embarrassing then that kind
of thing is really healing – when they can
start to see that the person who is
horrible is their partner. That’s not that
easy, it’s really not, because the women
who come to me will still self talk – she
doesn’t know what I’m really like, she
thinks it’s all him, if she knew what I was
really like-
Making The Invisible Visible
They really think they are dirty and
horrible and cause all the problems. I
know that they’re thinking that too. Do
you know how long it takes, to go through
all that? To do this you have to be patient,
you have to want to do this and most
people don’t because it’s going to cost so
much money to do that, or it’s a massive
loss of income but, absolutely, validation .
They have to find that person who gets it
and validate it and so to answer your
question, it’s really hard because there’s
not a lot of people out there who are
doing this. You want to have therapy with
someone who understands trauma and
who can walk through the core beliefs you
have now taken on, as someone who has
been abused because you take on core
beliefs, I’m ugly, I’m lazy, I’m stupid,
people don’t like me, people are
embarrassed for me, I shouldn’t go out in
public because I’m an embarrassment, so
you have all those beliefs playing out in
your day to day world. So you ask, do you
have friends? Do you see your friends? I
don’t have friends Why not? People don’t
like me. So you have to try to work out
where did all of that come from and then
challenge those ideas- that’s not an easy
thing to do and that’s why it’s so easy to
get into another relationship like that.
Prevention is far far better, the way I see
it. If we can get people talking about what
it really looks like - your friend is so hot I
don’t have to worry about others guys
picking you up - if you humiliate someone
enough,they will then choose not to go
out with their friends and they won’t even
realise that someone has told them not to
go.
M: You’ve absolutely hit the nail on the
head. Many of the examples used to
illustrate coercive control don’t really
show how a person is humiliated and
degraded. It is very much along the lines
of does he check your phone, which
doesn't go deep enough into how
someone can absolute annihilate your self
worth.
Making The Invisible Visible
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