Stopping the Cycle of Abuse

Although I have lived and worked in Great Britain for most of my professional life, my heart comes from the Americas, both from South America, where I was born and attended medical school, and first learned the rigors of psychoanalytical technique from my earliest mentor Horacio Etchegoyen, but also from North America, where immediately afterwards I undertook my psychiatric residency with Karl Menninger whose links to this organization will be well known to you all.

Menninger, in particular, had a huge impact on my work in the field of forensic psychotherapy and psychoanalysis. Dr. Karl was the first in helping me to learn about the cruel, unconscious hostility we project onto criminals, and how a more humane society can treat even offenders with greater compassion. Thus, my debt to American psychoanalysis is immense.

In the letter bearing official news of this honor, your president paid tribute to the difficult nature of my work because of the “negative countertransference evoked by these abusive women.”

I learned of this extreme predicament through my own personal pain and emotional distress. You see, we almost always automatically identify with the victim—and almost never with the aggressor-perpetrator.

But working for 30 years in the United Kingdom at the Tavistock Portman Clinic NHS Trust with male perpetrators, I discovered that their early lives were filled with at best neglect, or at worst with emotional, physical and sexual abuse, not infrequently caused by their mothers.

As a clinician I observed that the main difference between a male and female perverse action lies in the aim: Whereas in men the act is aimed at an outside part-object; in women it is usually against themselves, either against their own bodies or against objects they see as their own creations, their babies. In both cases, bodies and babies are treated as part-objects.

Therefore I began my quest in listening to these women's voices of despair and desolation, and from then on my aim was for these women to have not only a voice but also an ear This led me to the question: What if we start seeing these women themselves as victims?

So, the task was to look at the damaged-damaging mother as the product of at least three generations. If we are able to apply this mental construct, we are then able to apply our understanding, compassion and empathy needed to stop the cycle of abuse.

We have to challenge our strong tendency and assumptions to idealize motherhood to the extent of denying any perverse motivations on becoming a mother or in taking care of babies.

This was all covered in my first book Mother, Madonna, Whore, published in 1988. Initially the book was greeted with some controversy, but eventually the concepts were widely accepted and acknowledged, and since then a number of resources have been created to deal with abuse by mothers.

The fact that this first book has never been out of print does not worry me, because in a way it is an indication that even though these terrible malfunctions have not yet disappeared, at least they are now being acknowledged and discussed.

In 1991, with the aim of changing perceptions and creating an understanding, I founded the International Association for Forensic Psychotherapy, which built a platform and a forum for professionals working around the world in this field to gather once a year to discuss in a frank and honest environment our own difficulties encountered in our daily work dealing with abuse and abusers. With respect to mothers as abusers, Mother, Madonna, Whore was the first to acknowledge this painful and awkward, even “politically incorrect” insight.

Let me be clear, the effects of abuse are terrible and can be long lasting, but condemnation and abhorrence will not change behavior or provide the help those victims need.

Our therapeutic work is hard but it is the only solution. I pay tribute to you all for your precious work.