Suicide and the search for justice after sexual abuse

Brian Gergely, a survivor of sexual abuse by a priest and a staunch advocate for other victims, took his own life last week, just days after the Pennsylvania State Senate eliminated from a bill reforming sexual abuse statutes the right of past victims to seek redress in court. Mr. Gergely’s suicide evoked deep compassion from many Catholics and fellow survivors and advocates.

Some survivors and advocates opined that Mr. Gergely’s suicide stemmed from hopelessness following the senate’s action. Judith Weiss Collins, a survivor of sexual abuse by a member of the clergy in the Diocese of Allentown, said: “Talk to anyone who has been abused and the suicidal idealization [sic] is always there…. It’s just wretched...but loss of hope that is it…knowing you can't do anything. That we can't do anything to gain back anything that was lost.” This statement encapsulates some of the complexities of suicide and its relationship with sexual abuse that are important to unpack.

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Suicide Demographics. Suicide is a public health scourge that rests on myriad factors. Since 1999, the incidence of suicide in the United States has increased rapidly, picking up even more speed since 2010. Now 117 Americans take their lives every day. Suicide has increased among nearly every age group, but middle-aged white men appear to be a particularly vulnerable group. Experts have not reached consensus on the reasons for this uptick in suicides, variously citing as potential contributors: the economic downturn, the increase in intended overdoses of prescribed opiates for pain, the role of Iraq and Afghanistan in veteran suicides, and social isolation, especially of divorced middle-aged men who also may be jobless.

Suicide and Sexual Abuse. Survivors of sexual abuse in childhood or adolescence are two to four times more likely to take their own lives than non-abused individuals. The likelihood of suicide is more strongly correlated with early sexual trauma when the abuse is repetitive and the perpetrator is a family member. Sexual abuse by a priest is comparable to incest given the historic role of a priest as the spiritual “father” of all Catholics in his care. Additional risk factors for suicide, like alcohol and substance abuse, depression, impulsivity, relational losses, job instability or loss, previous suicide attempts, mood disorders, post-traumatic stress disorder, personality disorders and social isolation, are also common consequences of sexual abuse.

Further, while any kind of sexual abuse may disrupt the child’s relationship with God, violation by a priest frequently destroys God as a protective source of hope, instead turning the divine into a sadistic abuser or a careless witness who refuses to intervene. Brian Gergely, abused for seven years by a Catholic priest, was therefore at high risk for suicide. His great disappointment over the Pennsylvania Senate’s amendment to a bill he had fought for may well have been the contemporary trigger leading him to choose to kill himself.

But here is where things get tricky. While there is a well-substantiated and alarming relationship between sexual abuse and suicide, suicide is still rare among abuse survivors. Contrary to the quotation from Ms. Collins above, “only” about one third of survivors even think about taking their own lives, and far fewer actually do it. Unfortunately, I could not find any studies specifying the percentage of suicides linked to histories of childhood sexual abuse, or any addressing the percentage of survivors of sexual abuse who ultimately commit suicide. Researchers point out, however, that individuals who take their own lives usually have a plethora of risk factors, some of which co-vary (e.g., substance abuse and depression; substance abuse and social isolation; financial instability and relational loss). This makes it difficult to isolate the factors most associated with a given suicide.

After my 30 years of clinical work with survivors of sexual abuse, I estimate that 50 percent have had at least occasional suicidal ideation, and about 10 percent have considered suicide seriously enough to warrant additional clinical services ranging from a medication change to extra sessions, to brief in-patient stays. One patient took her own life. She, like most people who take their own lives, had a pastiche of risk factors: sexual abuse as a child, a parent who committed suicide, access to lethal means, depression, financial instability, a degenerative physical disease and the departure from home of her youngest child.

A Treatable Condition. A tendency toward suicide does not necessarily lead to an actual suicide.Any episode of suicidal thinking or intent is time-limited, even if those episodes occur regularly. The goal of therapy is to see someone through an episode, shore up or introduce protective factors and assist in accessing an ongoing source of help. Mental health crisis centers, the police and medical workers or hospital emergency departments are available to talk to and evaluate suicidal persons and point them toward additional help. The National Suicide Prevention Lifeline is open for phone or online chat 24 hours a day, seven days a week. The person in a suicidal crisis needs immediate attention; the person with recurrent suicidal ideation needs a healing relationship with a therapist or other trained professional.

Life After Abuse. The survivor quoted above feels that the Pennsylvania senate robbed survivors of hope that they can get back something they lost. The soul-searing truth, however, is that no court, no settlement, no public acknowledgement can give them justice. A childhood desecrated by sexual abuse, especially abuse perpetrated by a priest, can never be restored. It is unfair, but the task of the survivor who truly wants to heal is to mourn the unrecoverable loss of a deserved childhood, to go through the sickening process of relinquishing the hope of restoration in order to live into the hope of resurrection.

When this journey is successful, the survivor develops a life separate from the abuse. The inner demons are not fully exorcised, but they are tamed. It takes greater provocation to wake them; and less time, effort and pain are required to keep them at bay. At that point, any gestures received or triumphs gleaned from laws, lawsuits or church efforts are gravy for the survivor to savor, not essentials to make life worth living.

A Note of Caution. Suicide is contagious at times, and another risk factor is exposure through personal experience, media or the internet to the suicide of another, especially one with whom a person has something in common. The National Suicide Prevention Lifeline (1-800-273-TALK) provides information about suicide risk factors and prevention. The staff also provides guidelines for media discussion of suicide. It is irresponsible for anyone to react to an individual’s suicide without noting that suicide can be prevented, offering hope and directing to the Lifeline people who are considering suicide and those who are concerned about someone else who is at risk.

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Annie Patrick
1 year 4 months ago
“Mr. Gergely’s suicide evoked deep compassion from many Catholics and fellow survivors and advocates.” Hmmm, I haven’t seen any news or evidence on how the Archdiocese in PA ( who squashed this bill by spending millions lobbying against it and preaching from the pulpit against the SOL reform despite their supposed separated and tax exempt state), are experiencing or expressing compassion. Where are the sermons on how the lifelong effects of child sexual abuse are devastating for many? That for even those who seem to “make it” there is still significant vulnerability? That whoever should harm a child should have a millstone ….. Where are the pastors and Bishop letters demanding access to justice and reparative services for all victims? If the leaders of the Roman Catholic Church in PA (or NY or NJ and everywhere SOL reform for child sex abuse is needed) had true morals and compassion, they would have been in the trenches for years fighting for this SOL reform, right alongside Brian Gergely. They know the studies show the lifelong devastating effects. They know the research and reasons many kids cannot speak out until late in their life, if ever. So, in all due respect Dr. O’Dea, maybe some Catholics felt compassion, but the ones at the helm dictating to the masses; the ones who can make a huge difference feel, think, act and make large payments in a manner that is nothing akin to compassion for yesterday’s victims, today’s or tomorrow’s.
Mary Gail Frawley-O'Dea
1 year 4 months ago
You are correct that little support for legislative changes comes from the Church -- or any other institution like schools, companies, etc. But, the responses to Fr. Jim Martin's posting about Mr. Gergely's suicide and his posting of this article evokes over 1,000 compassionate comments from Catholics and other followers of his page. Ultimately, it is laypeople whose attitudes and votes will bring social justice, not the actions of institutions whose agendas are to protect their pocketbooks first.
Annie Patrick
1 year 4 months ago
Dr. O’Dea. Thank you for your kind reply. I apologize but I am unfamiliar with Fr. Martin and the post to which you refer. I am reading this article online. Perhaps there is a context and/or additional accompanying information I missed? Good to know of the compassion from so many. True, lay people are often the vehicle of social justice. They are also largely influenced by their faith and religious leaders. When the Bishops and Priests spend mass time preaching against legislation such as SOL reform for child sexual abuse or send letters home instructing parishioners to support one candidate over another due to their position on such issues, they are effecting legislative results. Sometimes the result is to keep legislation unchanged; sometimes to change it. They influence the lay people greatly. On this particular topic they use false propaganda including fear tactics to do so. Perhaps you meant little support for legislative change of a “humanitarian” and “just” nature come from the Church or other institutions, companies, etc? Because over $5 million in PA on this issue alone is no small effort by the RCC. Nor is the $2.1 in NY. The insurance companies have long been influencing this legislation as well. Lobbying is done by institutions and companies for the sole purpose of benefiting their specific interest, not the general public’s well-being. This is why grassroots, social justice and public health issues often get bulldozed by these wealthy and/or powerful entities that are indeed protecting their pocketbooks. Again, thank you for the article and reply.
Jeanne Marron
1 year 4 months ago
We can never fully know the state of another being at any given moment, let alone the moment when they decide to end their life and carry out that decision. Nor can we pretend to know all that goes on within those who have experienced child sexual abuse, one reason of many is that they never let us know it happened; some may be long deceased by suicide or high risk behaviors. However, we do know a lot and I think it is important to add to what Dr. Frawley-O’Dea shared. First, we know that ACEs (Adverse Childhood Events) which include child sexual abuse are correlated with lifelong issues of increased suicide rates and a number of medical and mental health issues such as cardiac disease, pulmonary issues, PTSD and suicide ideation, to name a few. The research is not causal, but let’s be clear, the ACEs precede the health issue and/or suicidal ideation; not the other way around. We can’t ignore the path in these corollary studies. In fact the emphasis in this article on the role of factors such as PTSD, depression or substance use in suicide risk seems bizarre as these are the other later in life corollaries of child sex abuse. So, yes, the child who is sexually abused is more likely to experience PTSD, depression, substance use and suicidal ideation. How does that “unpack” the CSA from the suicidal ideation? Trying to reverse the path and perhaps look at role of PTSD, etc as causal is counter indicated by the research so far. The PTSD and suicidal ideation are often co-occurring elements that are experienced AFTER CSA. Second, we know that standing against all causes of death, suicide is rare. However, each one is one too many as suicide is traumatic. It screams out anguish that could have been treated in the person who committed the suicide and it leaves those behind struggling with traumatic bereavement. Third, there are lots of studies available to look at the correlations between CSA and suicidal ideation and suicidal behavior. I encourage readers to do their research. The author seems to contradict herself in this arena. At times she draws from the research conclusions and yet states “I could not find any studies specifying the percentage of suicides linked to histories of childhood sexual abuse, or any addressing the percentage of survivors of sexual abuse who ultimately commit suicide.” She then turns to her own anecdotal experience to make her case; just as Ms. Weiss Collins drew and spoke from her anecdotal experience quoted at the start of the article. So, whose anecdotes do we believe? Whose research do we read? Fourth, I am not sure my last two questions matter because even a 50-60% rate of suicidal ideation in a treated population is huge and worth noting. This is a major issue in CSA. One suicide is too many. Fifth, I wonder about when one adds in the impact of other types of abuse and/or loss of coping strategies. For example, when the child sex abuse is perpetrated by a representative of a deity in a religious institution; that religious person, religious institution and deity might have served as a protective factor had it not been the context of the abuse. In these cases the child suffers religious and spiritual abuse as well. Six, True, the losses experienced by CSA are not recoverable. However I am in need of clarification as to what Dr. Farley-O’Dea means by “relinquishing the hope of restoration in order to live into the hope of resurrection“ when she states: “It is unfair, but the task of the survivor who truly wants to heal is to mourn the unrecoverable loss of a deserved childhood, to go through the sickening process of relinquishing the hope of restoration in order to live into the hope of resurrection.” I have to believe there is restorative capacity that comes from within the survivor, albeit often with skilled assistance from others. Why take that hope away? That is what many survivors look for. They are not trying to replace a lost childhood and forever altered development and being. To effect an internal transformation of being despite the CSA that is not dependent on others dictates and is at peace with its own agency and present with the world is more likely. “Hope for resurrection” sounds mythical and incredibly religious for those referred to on the article that experience Religious CSA. 7 – There is no life separate from the abuse. Please see Van der Kolk and others work. This is encoded in the nervous systems of the individual. The neural encoding are not demons to be exorcised. The encoding and things like PTSD symptoms are normal reactions to trauma. In the case of CSA, the encodings are from the actions of demon like people who harmed the child. I have to take exception to the article suggesting an internal demonic existence in CSA survivors. There is nothing demonic or bad to be exorcised. There is some horrendous experiences encoded within that have far reaching implications for their life that need attention and hopefully some healing. 8- Any “exorcism” needs to be of the actual, external predators and their protectors from today’s youth. It is the perpetrators and their abettor’s actions that gave rise to the painful internal states of the victims. Less abusers; less damaged people. 9- Removing the perpetrators of child sexual abuse via better laws is not “just gravy” and as I stated earlier, we never truly know what makes “life worth living” for a CSA survivor. 10 - Removing perpetrators and holding them and abettors accountable via better laws is of vital importance to many survivors. They are often tortured knowing the people who damaged them are still out there, likely doing the same today. 11 – Being denied their basic civil right of access to justice is also of vital importance to CSA survivors. It makes them feel a non-entity again and often triggers feelings of re-victimization. Fighting for CSA SOL reform, as Mr. Gergely did, can be a grueling, exhausting and unrewarding process, albeit one that many survivors stake a lot of internal reserve toward. There is literature on the role that attaining justice and accountability as PART of the recovery or healing process. 12 – None of the fight for SOL reform or Justice for CSA survivors will ever be “gravy.” This is a social justice and public health issue. This is a hard, long, ever faltering battle against the power and money that keep the draconian laws in place. The current laws Mr. Gergely fought fervently to change, allow CSA to continue by keeping sexual predators and their keepers untouched. The laws are important. They open or close access to justice. They reflect moral imperatives. The survivors are fighting a modern day civil rights issue. Note: My condolences again to Brian’s loved ones and fellow advocates. To all those following this and other stories about Brian, please remember if you are struggling there are people to listen. Call the Lifeline: 1-800-273-8255
Mary Gail Frawley-O'Dea
1 year 4 months ago
Jeanne: you took so much time and effort to respond to the article the you deserve a thoughtful response. In terms your paragraph: First, I do not think we disagree that ACE of all kinds and CSA in particular is correlated with suicidal ideation. And that sequelae covary. We also know that many suicides are enacted by people with no history of CSA. I was arguing causality, not correlation. Second, I do not disagree and certainly intended to make clear that one suicide is many too many, which is why it is so important for anyone commenting on it publicly to cast it as something that can be prevented. Third, once again I actually said in the article that research indeed verifies a significant correlation between CSA and suicidality. As you must know, if one looks at the universe of folks who suicide one can identify a number of common patterns, pre-existing experiences and symptoms. However, if one looks at the universe of everyone with those patterns, experiences, and symptoms, the vast majority do not suicide and most never consider it. Again, I am differentiating between correlation and causality. Fourth, we do not disagree here at all, which is why my Center screen for suicidality in everyone and tracks it carefully in CSA survivors. We have a Beta Team, in fact, -- me, our medical director, and an experienced psychologist. One of us is available 24/7 and must be contacted by any of our therapists who have a patient about whom there are safety concerns. We walk the therapist through the situation and meet with her/him after it to unpack what happened and what, if anything, could have made our services more effective. Fifth, no disagreement here. In fact, one of the worst aspects of the church crisis is/was that fellow priests, hierarchy, fellow parishioners further betrayed the victim by offering no support or, worse, blaming the victim or turning away from him/her. Sixth -- what I am talking about is the potential for moving form a survivor who happens to be a person to a person who happens to be a survivor. One can never restore a lost childhood, but one can transcend history to live a full life not dominated by the past abuse. 7: You misunderstand me. The internalized "demons" are the flashbacks, memories, self-hatreds, shame that should have been assumed by the perpetrator and instead are carried by the victims, etc. All that once was external becomes internalized and, from within, tortures the victim AS IF it is still occurring. That is what good treatment can change. And, thank goodness, we now know and have PET scan evidence, e.g. Van der Kolk, that the neurobiological consequences of abuse indeed can be changed over time -- through medication, mindfulness, mediation, body work, new attachment relationships, etc. 8 -- I do not want to conflate the very important work of prevention with the work of healing what has already occurred. So we do not disagree here. 9 - You misunderstand me. I agree that laws that prevent abuse and make it easier to hold perpetrators and their enablers to account are vital -- which is what the PA law under consideration does. My argument is that if the work of healing has not been done, winning a lawsuit or being able to launch one does not help healing -- we have seen a good number of suicides after litigation is filed or after checks are cut. Those activities CAN, however, bring ADDITIONAL material and emotional succor to survivors who paradoxically are not counting on it to somehow free them from the symptoms of PTSD and CSA. 10 -- Agreed. see 9. 11 - Right now, there is not laws making these "basic civil rights" in every state. And I agree that, once a good deal of healing has occurred, working for social justice for CSA can bring additional healing. It can turn a sense of helplessness into empowerment, which is healing in and of itself AS LONG AS it is the process and not the outcome on which the survivor is depending for those feelings. Changing laws and minds and hearts about cause is comparable to changing them about guns or race -- it is a LONG, LONG, LONG slog. 12 - I agree -- see 11. I hope this clarifies some of where we appeared to disagree.
Mikele Rauch
1 year 4 months ago
I am a trauma therapist, working with survivors of sexual and religious abuse from people from all religions for 30 years--and a survivor of religious and sexual abuse. It is true that new laws, lawsuits, and certainly the weak responses of clergies or religious bodies rarely if ever make any deep difference in breaking free of the trauma of such abuse or make life worth living. Yet, I disagree with Dr. Frawley-O'Dea, whose life work and writing has mentored and informed my own work. I do not believe that one can ever separate oneself from their abuse-- It is impossible to simply compartmentalize a life, or the violations of such abuse, especially when the soul is involved. Unfortunately, religious abuse is often only one aspect of a lifetime of trauma, and so the betrayal in this context is even more profound. Suicide Prevention Hotlines at such times are often under-utilized because by the time people are in that space, they have already decided to end their lives. The question of choosing life or death after the losses and violations of religious and sexual abuse is complicated. It must be reckoned with. But it is possible to break free. It is possible to hold the conundrum of life and death- and find meaning in living again. One needs good therapy with someone who is trauma informed and willing to be tested themselves and go the distance in recovery. And, one may need reconfigure a way to hold their soul and to grapple with God or Self or however they name it as well. There is no way to be in this without support of those honest and willing to bear the unbearable together with fierce compassion and a commitment to truth. And, it is possible to be safe enough to face the darkness, and to laugh again, love again, and be fearlessly ourselves again--but we can not do this alone.
Mary Gail Frawley-O'Dea
1 year 4 months ago
Hey, Mikele: I do not disagree with anything you are saying. It is tough in 1,000 allotted words to be a nuanced as the subject calls for. What I was aiming for is to say that it is possible to move form being a survivor who happens to be a person to a person who happens to be a survivor. Not that it is like the abuse need happened, but that it no longer runs one's life. I hope you are well and doing the wonderful healing work that you do. --mg--

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