When I met Jane Doe she was seated under a crucifix in a chapel in a church-based homeless shelter. She sat patiently in the light reflected through a stained glass window. As a psychiatrist working with homeless women and children, I often saw women there; it was the only place that could offer some privacy. Jane was about 35 years old. Her appearance was unremarkable.
I walked up to her and introduced myself. She reached into her purse, took out her wallet, and gave me her driver's license. The picture showed a woman whose left side of her face bore no resemblance to the right side. The left side was swollen, and her blackened left eye was shut. She said, “That's a broken jaw, a busted face, and a black eye. I could not talk for months, but now I'm better. My name is Jane.”
I asked her what had happened.
“My husband.” she said. “It was my birthday present. Right now I have other things on my mind. I got here from Mississippi last month.” She showed me the summons from a state's attorney in a Mississippi court. “I called my husband and he says he told the court that I abducted my children. He says that he got the case fixed and that he has the law in his pocket.”
“You angry?”
“No. I'm past anger. I'm going to kill him.”
I looked at her face once more. “You mean it?”
She showed me her wallet and counted out a few twenty dollar bills. “I used to work as a waitress. I have money. This is enough to get a bus ticket to Mississippi and back. My brother has a gun. Does it look to you like I'm kidding?”
After reflecting, I said, “No. But I must tell you, if you insist that you want to kill him, I will have to put you in a hospital.”
“You gonna lock me up in a loony bin?” Jane looked at me. “I look crazy to you?”
“I have to do what I have to do. It's my job. I even have to tell him. But first, I have to decide if I think you are a danger to others. I have to know more about your story. Tell me more.”
“When I was young, he looked so right. After I got him, my stepfather quit bothering me. … My husband knows I love those kids. He says they ain't his. I should have listened to my mother. She said, ‘He ain't right for you.‘ My mother is dead. If my mother were alive, she would have helped me. … If she could speak from the grave, she'd tell me what's good for me.” Tears rolled down her cheek. I offered her a tissue. She took it and wiped her face.
“I have two darlings — 13 and 10. Two boys. They are my life.” She talked about them and her hopes for them. “They hate him, too. When he was drunk he beat me and whupped them.”
“You've had a rough life. How would killing him and being in a prison help your kids? Do you need to kill him more than your kids need you?”
“If my mother were here, that's what she would say. ‘He ain't worth a bullet.‘ ”
“I think you are imagining what your mother would say and figuring out what to do. I need to know whether it is still your intention to kill your husband.”
She spoke softly but firmly. “I changed my mind. My kids come first.”
“What changed your mind?”
“You heard me.”
“You have a lot on your mind, and I think you need to talk some more. Do you want to see me again?” She smiled in obvious relief and said yes.
I saw Jane a few days later in the basement storage room of the church. The smell of stored donated food hung in the air.
“I didn't get on that bus!” Jane continued speaking as though there had been no interruption since the last time she saw me. She told me that she was planning to go to court and explain her side of the story to the judge. “When he hit me, my kids would try to jump in the middle and say, ‘Don't beat Mama.’ He punched them too and said, “You stay out of this, boy.’ ” Jane became animated and boxed the air as though it she were beating her husband. ”Pow! pow! pow! pow! pow!“
“You are reliving those hard times. This stuff is fresh on your mind and it comes back to you again and again.”
“I can't get it out of my mind. Once on my birthday he said, ‘Hey bitch, suck my dick.’ I didn't move. He walked to his dresser and got out his gun. He stood in front of me and slowly put a bullet in the chamber and spun it. He put it in my mouth and pulled the trigger twice. It didn't go off. He said, ‘This is your lucky day. I ain't gonna kill you, but you're not gonna forget this birthday.’ Then he punched me in the face and stomped on my face with his shoes.”
“I moved out and got a new apartment. One day I was in the kitchen with my kids frying hush puppies. He broke in through the back door. I asked him to leave. He said, ‘You gonna make me turn back?’ I asked him again. He took one more step toward me. I threw hot grease at him. I said to him, ‘Bitch,’ as I threw more grease and hit him with a frying pan. He began to scream and howl like a kicked puppy. ‘Go call the cops,’ I said.”
“You did to him what he used to do to you.”
Jane said, “Yes.” She was excited. “Thank you for trying to understand me and not judging me.” She told how he came back another day and screamed, “I'm gonna kill you.”
“I ran from the back door, through an alley to the street. ‘Help. Help. He's gonna kill me.’ I ran into a liquor store and screamed, ‘The father of my kids is gonna kill me.’ ” She was screaming as she told me this. “The store owner told me to come inside. My husband came and said, ‘Don't come between a husband and a wife.’ The store owner called the cops. They handcuffed him and booked him. My kids saw the cops from the windows and they shouted, ‘Don't let him come back. Kill him. Give him the electric chair!’ ”
Her ten year-old son knocked on the door of the basement room and walked in. “Mama, what's for dinner?”
She put an affectionate hand on his head. “This is Dr. Sripada. I'll be out soon.”
“Oh, he's the one.” He shook my hand and left.
Jane said, “He asked me this morning, ‘Mama, are you gonna kill daddy?’ I told him, ‘No. I talked it over with the doctor. I'm gonna let the Lord whup his ass.’ ”
She had made remarkable changes in a short period of time. Her unassuming face now seemed unforgettable. I said, “You have made a lot of changes.”
She shook my hand and said, “Not by myself alone.”
I am a consultant at the Shelter Outreach Program of the Beacon Therapeutic Diagnostic and Treatment Center, a mobile community mental health center that serves about 18 homeless shelters for mothers and children. These shelters are run by various philanthropic organizations, including churches, under the auspices of the city of Chicago. A team of mental health professionals provides mental health assessment and treatment. The main problems are parent-child difficulties and stress resulting from poverty, domestic violence, and drug abuse.
The psychoanalytic ideas I find most relevant in working with this population are based on free association, non-directive but active listening, Freud's notions of active mastery, Anna Freud's identification with the aggressor, and Leo Rangell's ideas on intra-ego conflicts regarding choice and decisionmaking.
Many women living in homeless shelters have been abused as children. Because they could neither fight or flee, they had no opportunity to work through their trauma. Their own parents were often the perpetuators of the abuse, or at least colluded in it. Such parents actively discouraged exploration and usually did
Bhaskar Sripada, M.D., is an adult and child analyst on the faculty of the Chicago Institute for Psychoanalysis and an associate clinical professor at the University of Illinois.
not want to hear the child's story. Often the young children were blamed for seducing family elders. Because the children's perceptions were not acknowledged, they had no opportunity to develop a narrative of their life. A life story requires a willing listener and developer.
Active listening requires the analyst to be aware that he or she is not neutral. Even silent listening is as much a constructive component of the treatment as questioning. Listening may have some capacity to effect psychological change. The listener is not merely obtaining a history, but is also co-creating change by helping the patient construct a more coherent narrative.
The homeless women quickly recognize and make use of the opportunity to talk. Many of these women labeled this “freedom of speech.” The phrase, while similar to “free association,” also includes a sense of a free being. “Freedom of speech” has a very high value for them and seems rooted in notions of emancipation and equality like those expressed by Martin Luther King.
Because they could not work through the traumatic experiences of their own childhoods, many of these women unconsciously identified with the aggressor. They developed excessively punitive styles of discipline. Sometimes, a pathological attempt at active mastery takes the form of unconsciously maintaining or seeking out dangerous relationships. This pathology continues the cycle of intergenerational violence. Conflict resolution by direct action prevails rather than negotiation or compromise. Cultural patterns of discipline including punitive punishment are considered normal in many families, and their deleterious consequences are not recognized. Such disciplinary patterns can lead to violence.
Jane's case demonstrates Rangell's notion of choice and dilemma. My approach to her did not deal with a pre-existing ego conflict or dilemma but instead created a new one. When the attention of a mother is properly focused on her responsibilities to her children, she is often able to exercise maternal concern and then reason and act accordingly. A psychical split was transformed into a conflict.