Judith Lewis Herman

-Judith:
Hey!

Adi:
Before we begin, I have to say that I am so excited! It is such a huge honor that you have agreed to take this conversation.

How would you present yourself to a complete stranger?

I'm a psychiatrist who specializes in the impact of interpersonal violence on psychology or psychological trauma, if you want to use those terms.

Could you please tell us about the first steps you took as a therapist?

Well I guess that would be in my psychiatric residency, which began in 1970 and I began by seeing patients on an inpatient service, patients who were hospitalized for things like suicide attempts or psychotic breaks and for other severe conditions. My second year I also spent on an inpatient service in a large state hospital. In those days, we still had what you would call ”insane asylums”, where people with severe mental illness spent years, and I did my training there. But along the way, some of the patients I saw as inpatients got better and left the hospital, and I continued to see them as outpatients. I learned by immersion, if you will.

I guess I should say that as an undergraduate in college I had volunteered to be a part of a group that would go out to an asylum, a mental hospital, and spend time on the wards with the patients. So it wasn't my first exposure to people with mental illness. But it was my first professional exposure.

Was there a meaningful factor in your personal history that brought you to become a therapist?

Oh. Yes. I guess the meaningful factor was that my mother was a psychologist, and a psychoanalyst.  She had a private practice in our home.  She also participated in academic research and later on in her life, taught at Yale. And so I guess you would say she was the first influence in my choice of profession.

Could you recall maybe a specific event or events that shaped you as a therapist?

Yes. I think I would say two events. One is that my first two patients on the inpatient service when I began my residency were women who had been hospitalized after making suicide attempts, and both of them in the course of my work with them disclosed history of father/daughter incest. At the same time that I was doing my residency training, I was also participating in a feminist consciousness-raising group and learning from people's personal sharing about the prevalence of violence against women and sexual exploitation. And so I was able to hear my patients with that conceptual frame, and so I did not discount their or discredit their reports. I took them seriously. It also became clear to me how the early introduction to the life of a sex object had formed their psychological development and led them to the kind of self-loathing and despair that resulted later on in suicide attempts. So I saw incest, really, as a paradigm of patriarchal oppression, and having that frame actually enabled me to work productively with my patients and they got better! I continued with them after they left the hospital. And they did well. To have the secret shared and witnessed and not to be shamed or blamed was incredibly therapeutic for these women. They were able then to take major steps to take charge of their lives and their relationships.

Another event was with one woman who had been in a severe battering relationship and was able to leave the relationship safely. There were no battered women's shelters in those days, so the inpatient unit served as a shelter for my patient, truly as an asylum. When the husband got wind of what was going on and realized that she might not return home, he came on the unit and threatened the unit director, who was a man. And you have never seen the police called so fast. They came and they took him away and they hospitalized him and pressed charges. It was a lesson in who is it okay to threaten and beat and who is it not okay to threaten and beat, for all of us. Later on when my patient's divorce was finalized, I received two dozen long stemmed roses from this man, which I took to mean they were for my funeral. It's the only time I've received two-dozen long stemmed roses, and they were very beautiful, but I threw them in the trash. So I would consider that a formative experience.

This leads us to the next question, which is- how did working as a therapist in trauma influence your personal life? Your parenting? Your relationship with your significant other?

Well, in terms of personal life, I did become more aware of personal safety and boundaries and in terms of my parenting, when my daughter reached adolescence I insisted that she take a self-defense class, at which point she said to me, "well, what about you?" She made that a condition, and so actually she and one of her closest friends and I and her friend's mother, who is a close friend of mine, took a Model Mugging class, as it was then called, together. It was a fabulous experience. We were one of three mother-daughter pairs in a self-defense class designed with violence against women in mind. There were a male and female instructor. The female instructor taught how to defend yourself when you were lying on the floor pinned to the ground. And the male instructor (who wore incredibly strong protective gear including a huge mask and helmet), acted like a predator including all the verbal threats and verbal humiliation and name calling. All the intimidation tactics to simulate real life, and you were taught to fight until you delivered a knock out blow, mainly through your legs. But also we're taught to recognize weak points, eyes, larynx, abdomen, and obviously genital area and kneecaps, feet, where you might be able to deliver a good kick. So that was a formative experience also.

And by the way, the last class was a performance where the fights were witnessed by family and friends, whoever you wanted to invite. Each one of us had to get out on the mat and do our fight. And when I and my friend Emily would get out on the mat, it was sort of like, "Oh my God, why am I here? Do I really have to do this? I guess I have to do this." And when our daughters would get out on the mats, it was sort of like, "Hey! Bring it on!" So that made me feel that there was hope for the future.

More on that point, you do encounter a lot of difficult situations as a therapist in trauma. how do you preserve yourself?

Oh, I had a wonderful, wonderful group of colleagues. Together with a psychologist, Mary Harvey, I founded an outpatient trauma program at Cambridge Hospital called “the Victims of Violence Program.”  And over the years we built up the program. We had really incredibly gifted trainees and staff, and they were just an amazing support group.

So my main advice to clinicians is never to do this work alone. Never allow yourself to be isolated. It's not bearable. Trauma is contagious when you bear witness to the horrible things people are capable of doing to one another. First of all, you develop your own secondary symptoms of traumatic stress, hyper-arousal and nightmares and so on, but also you begin to despair of the human race. So having people who are bearing witness with you who are so inspiring and so devoted and caring is an antidote to despair. You know, you see the best and the worst that people are capable of.

Are there people you consider as mentors and how do they inspire your work?

Oh, gosh yes. Well my mother, first of all, obviously. And then in college I had a mentor who was a professor of Anthropology who had done studies of French villages using the methodology of participant observation that was generally used for "primitive cultures." And he actually enabled some of his students to spend time in a village that he had spent time in, to make our own observations and encouraged us to write a book with him, to participate in writing the book. He was a Quaker and ran our seminar like a Quaker meeting and he encouraged shared projects, so that we weren't constantly competing. He also encouraged us to trust our observations. So he was an important figure.

And I guess in residency I had a number of supervisors who encouraged me to trust my observations, even though, at the time the Comprehensive Textbook of Psychiatry estimated the prevalence of all cases of incest at one per million. The dominant ideology was that incest was fantasy based on children’s desire, but nevertheless  I had very good supervisors who understood the dynamics of incest.  One was named Davide Limentani- I think he was also a refugee from Italy.  There was an old tradition of very devoted psychiatrists who would actually live at the asylums where the mental patients lived and be part of their care, be part of the big community that they created there. He was a wonderful supervisor. There were others, many others I could name but that's probably enough.

Now on a different topic a little bit about how you work. When you were writing your books, what did you feel was most challenging, and what was most rewarding in the writing process?

Well I think that the challenging part was getting started. Really grappling with the material and trying to create some order out of chaos out of all the material. Your observations, your readings, contributions of others. So learning to recognize what you don't know, what isn't known, what original ideas you can contribute, all of that takes a lot of rummaging around and feeling lost at the beginning. Because if it's an interesting question or a hard question, it's a hard question, so you have to grapple with it.

And the rewarding part is once you've got an outline and a first draft and you're ready to really write from a place of greater confidence and passion. It's the only time I've ever had the feeling of flow or being in a kind of inspired altered state. I would sit down to write in the morning and somehow it would be eight in the evening and I would hardly notice that the time had passed. That was a joyful and wonderful experience that I hope to experience at least once more in my life.

 

 

 

 

 

What is your next goal and destination?

Well, you know I've just finished two book projects.  At the Victims of Violence Program we developed innovative models of group treatment and to me, group treatment is an incredibly important and underutilized treatment modality, especially where issues of shame and secrecy are paramount as they are with trauma. Because the group acceptance and the witnessing and compassion of peers who've been through the same kind of experience is entirely different kind of witnessing from the witnessing of a professional therapist. We understand from our professional training but to be in the room with others who have been through the same experience or similar experience is very liberating for many patients.  But of course, it has to be a well run group. So we developed group models for early recovery and then for what we call the “second stage” or trauma-focused stage of recovery. We published those clinicians’ guides in 2011 and 2018. I and colleagues from the VoV program.

In 2017, I also was instrumental in publishing a book of witnessing called The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Professionals Assess the President. This year, a second edition has come out with 37 psychiatrists etc. It was a best seller for a while, and I think it has contributed in some way to the more general understanding of what it is that we are dealing with currently in our slow moving constitutional crisis in the US. So that book's done. The group books are done. The more professional books – well they're both professional books of a different sort.

So now I want to come back to a project I started over 15 years ago. I wrote the concept paper, and then life intervened, particularly my husband fell ill and died, and I had to adjust to widowhood, and in addition I have myself a disability that means I need to live in assisted living, so for over a decade my personal struggles made it basically impossible to proceed. That project was about reimagining justice from the point of view of victims, because certainly in the United States justice system, the voice of the survivor is basically absent except in a circumscribed role as a witness. But as a stakeholder, she’s not recognized.

Our justice system is well designed to protect the individual citizen from the power of the state and therefore tilts the scales in favor of the defendant. And that's great for political dissent and things like that. It protects people in what's recognized as the public political sphere, the realm of man. But in the private sphere of men and women, parents and children, it privileges patriarchal power. And so, it's not surprising, for example, that rape is the least reported of all crimes, certainly of all violent crimes. The highest estimates don't go more than about 30%, but probably under 20% or even 10% of rapes are reported to police, depending on the study. And if you further reduce those, if you bring those cases to the criminal justice system, the presumption of innocence for the defendant means the presumption that the witness, the victim is lying. Right? And really the presumption of guilt for the victim. And it's the victim who is on trial.

The percentage of people accused of rape who are actually charged, tried and convicted is very low. Because most victims don't want to go through a process that seems stacked against them, or even if they do, the district attorneys don't want to bring charges because they don't want to bring cases that they can't win. And if it's his word against hers, his word is privileged. So, we have a justice system that basically enables gender-based violence, that is in incapable of dealing with gender-based violence.

My initial project was interviewing survivors of sexual and domestic violence and asking them what they would consider a just resolution, if they could write the rules. If they could envision what could make things right (if anything could make things right). Of course their visions of justice were quite different from the punitive system that we have. They weren't into punishment very much. They were into acknowledgement, first of all, of the facts, and of the harm, and acknowledgement not necessarily so much by the perpetrator as by the community that allowed it to happen and that was in some ways complicit. Their goals were acknowledgement, denunciation of the crime, lifting the burden of shame from the victim, bringing it to the shoulders of the perpetrator, and then following that, whatever means were needed to prevent the perpetrator from harming others.  And that might mean imprisonment, but only if it was a serial perpetrator who had been doing this over years and years and years and showed no sign of remorse or even recognition that what he had done was (wrong), basically someone whose sense of entitlement and privilege entitled him to a seat on the Supreme Court.  We currently have two credibly accused perpetrators sitting on our highest court. So we need to re-envision our justice system, and that's what I want to write about.

Well, in the fifteen years since I wrote my first paper, nobody else has written it. So I guess I have to.

What values did you grow on?

My parents were first generation Jewish Americans. Their parents were refugees from a pale of settlement in Eastern Europe.  My paternal grandfather worked in the garment industry all his life and was a devoted union man. And his son, my father, came up through the public university system in the City College of New York and became a professor of Classics.

My maternal grandfather, for whom I'm named,  Yehuda Block, came over alone as a teenager from Riga, Latvia to avoid the draft in Russia, and also because he had been caught reading revolutionary literature. He also went to work in the garment industry but saved up money and got medical training and became a general practitioner on the Lower East Side of New York and prospered and did well as a doctor. I think my mother would have followed in his footsteps had medical training really been open to women at that time. She initially, I think, was hoping to become an academic psychologist at Brooklyn College, which was part of the City University of New York. She was very active in the Teacher's Union and was then blacklisted and accused of membership in the Communist Party of the US. I don't know whether in fact she was a member but certainly, both my parents shared leftist, progressive political views. When I was eleven, my parents were called before Senator McCarthy, who was kind of a predecessor to our current president in terms of demagogic political power.

To the question “are you now or have you ever been a member of the Communist Party?” my father answered “no” and was able to keep his job at Brooklyn College. My mother, who  refused to answer under her privilege according to the Fifth Amendment to our Constitution,  was blacklisted and because she could no longer get a job as an academic, took the money that was left by my grandfather after his death and got psychoanalytic training. There were many Jewish refugees in New York who had come over during the late 30's, early 40's to escape Hitler who were happy to provide “bootlegged” psychoanalytic training to psychologists. (The American Psychoanalytic Association was then restricted to physicians.) So she got her training and had an active practice.

When I was growing up, I myself was active in the Civil Rights and Anti-War movements in the US, and then growing out of that, the Second Wave feminist movement. And I would say the political frame, that conceptual frame that was the part of my legacy enabled me to see psychological trauma as a condition of the powerless and to see the dynamics of trauma as the dynamics of dominance and subordination. This is the fundamental insight that I try to teach and I think is part of all my books.

Is there a message you would like to convey to future therapists or what kind of legacy do you hope to leave with therapists.

Sigh. I don't know. Trust your gut. Find your support group. Don't be afraid.

how do you take your coffee?

I don't. Coffee and caffeine makes me much too jumpy. So I like tea. With lemon.

How do you wind down?

Music. I have a cat. The cat is excellent. A purring cat…cats are extremely pleasure oriented and they know what's good. They insist upon it for themselves. We live to serve. They are good company.

What would you tell the 20-year-old Judith Lewis Herman?

I'd probably tell her what my momma told me. First,  get medical training.  I told my mother, I think I want to be a psychologist like you. She said, "No, no, no. Go to medical school. You'll have much more power." That was good advice. I'm glad I did that. What else would I tell her? Well other advice that I got from my mama… Pick your battles, that's one.

And activism is an antidote to despair. So those two. And then from my dad: language is important. He chose his words carefully. Languages were his field. And when I wrote my first book on father daughter incest, which I thought might upset him a little bit, he ignored the content and simply gave me editorial suggestions, copy editing suggestions which were spot-on.

What is your guilty pleasure?
Sweets.

do you think every therapist should also be politically involved, or an activist?

I don't know. I don't know. You have to want to do it. You can't- It's not something you can have imposed upon you. Do I think it gives you a better perspective on your work? Yes. Do I think it's essential? Probably not for everyone.

 It's a good idea. It gives you a wider lens, but you don't see everything. You still have to think on multiple levels. You have to think biologically, psychologically, socially. And that's not easy for people to do. A lot of people just can't do it. I mean I know. I've supervised a lot of people. Some people get it. Some people don't. But ideally, you'd want to be thinking on all those levels, yes.