Lucia, now 71 years old, underwent therapy that revealed the lasting impacts of witnessing family violence as a teenager. She saw her father try to cause her mother to miscarry, and later two of her aunts died after experiences of domestic violence. Lucia began exhibiting mood swings and strange behaviors a decade prior, after learning her daughter's husband had an extramarital child he hid. Her therapy uncovered how these past traumas shaped how she perceived subsequent difficult events and interactions later in life. Examining Lucia's full history and subjective experiences was important to understand the origins and nature of her suffering.

1. LATE SEQUELAE OF INFANTILE HELPLESSNESS
“Who can tell whatever happens to a 14-year-old-girl, a big sister to be, when
she realizes that her father wants to put an end to the life of his unborn child and
she feels that there´s nothing much she can do about it?”
Felipe Rilova Salazar 1
I. INTRODUCTION
This paper deals with the psychological path of a 71 –year old woman, whose therapy revealed the magnitude of
her sequelae after having witnessed serious situations related to intrafamiliar violence in her early teenage years.
The worsening of her sequelae later conditioned the way she faced other similar events of different origin, some
of which were social in nature.
The unveiling of the suffering that accompanied her throughout her life led to the recognition of reciprocal
interactions acting as the foundation of the predicates of violence (family violence, gender violence, political violence,
state violence, medical care violence). Moreover, some specific outrageous situations had a particular repercussion.
II.
a. Lucía
The person these lines describe will be called Lucia, a 71-year old woman with bright and lively eyes. A widow for
the last 25 years, Lucia has three daughters and 5 grandchildren. Her parents had a long life. However, and apparently
for economic reasons, she and two of her sisters were brought up by two aunts on their mother´s side since early
childhood; however, they never lost touch with their parents since they all lived in the same neighborhood.
As for her marriage, Lucia evoked the idyllic nature of the bond she and her husband had, and underlined the
deep devotion he felt for her. They married when they were still very young: “We were like two kids back then”. She never
had a partner after her husband died. She worked as a first grade teacher in a public school for thirty years.
At present, she says she still likes dealing with children for she is very keen on them. Lucia calls herself the “the
gang leader” when she refers to her grandchildren and herself. One summer she wrote the plot of a comedy, and created
a role for each of her grandchildren. The acting, as they all recall, was unforgettable.
1
Physician specialized in psychiatry. 957 Cabildo Avue. 12 “C”, C.P.1426, C.A.B.A., Argentine Republic. feliperilova@gmail.com
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2. Not only her daughters and grandchildren but also the rest of the family is fond of her. Her sons-in-law are keen
on her too. And it was precisely upon the request of one of her sons-in-law, her younger daughter´s husband, that I first
visited Lucia in order to discuss the possibility to treat her. At that moment, she had been admitted to a neuropsychiatric
center a couple of days before.
When we had our first interview, Lucia had been on psychiatric treatment as an outpatient for three years. She
had been on psychotropic medication with no satisfactory response. After our first interview, I could see that Lucia had
not been given the kind of care that is related to the epistemological field of “being listened to”. Let´s make it clear,
though briefly, that “being listened to in terms of medical care” means the therapist should keep quiet in order to create
the quiet atmosphere where you can listen to the beats of hidden pain.
In this sense, Lucia had not been listened to; she had only been “looked at”, and according to the therapeutical
criteria of “being looked at” Lucia had been typified; that is to say, included in a category called “picture”, drawn after
checking a given number of evident elements that the carriers of such entity may typically exhibit. In her particular
case, mood swings and certain crazy behaviors appeared as the “visible” components of her “typical” picture. It should be
stated that insufficient care added to the epistemological concept of being looked at means that no effort is made to
unveil what the “visible” components mean for an individual.
In that health care center most of Lucia´s relatives made unsuccessful efforts to act tactfully and sometimes even
joyfully to support her. Her treatment was focused on the “what”, “what” picture she presented; “what” signs the picture
depicted; “what” psychotropic drugs might be good for her. Her family, on the contrary, wanted to confirm “who” she was.
Apart from her daughters and grandchildren, Renata, her sister and 15 years younger, accompanied Lucia in her
hospitalization with peculiar fondness. Renata was the youngest of four sisters; the only one who had not been brought
up by their aunts.
The day before our first interview in the clinic, I had a preliminary interview with her youngest daughter in my
office. I could then understand that Lucia´s personality changes went 10 years back, precisely the moment when her
eldest daughter´s husband had confessed the existence, long silenced, of an extramarital son.
Although Lucia´s daughter and her husband had managed to keep that secret, and this extramarital child even
often visited them, it was obvious that Lucia had not been the same ever since. However, things got worse seven years
later, and for the next three years she saw many different psychiatrists. Finally, she was hospitalized.
Lucia´s suffering during those three years featured stages of expansive mood when she appeared restless,
talkative and irritable while other times she was downcast, emotionally unstable and weeping. Amidst these mood
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3. swings, she went through stages of intense fear, and locked up in her apartment, a place where she did not find calm
either, for more than once she had to struggle with the idea of jumping out of the balcony. Moreover, she occasionally
exhibited some “funny” behavior. For example, one summer vacation one of her daughters caught her askance as she
was taking off her bra to try and breastfeed a teddy monkey that belonged to one of her grandchildren.
In spite of all these facts and the type of professional medical care, it was clear that the alienated-person label
Lucia exhibited had not been enough to damage the leading role she played in the eyes of her loved ones.
Apart from the diagnoses she was charged with and the sidelining inertia that typically follows, truth is that in
spite of psychiatric labels Lucia was still respected by her loved ones. In this sense, Lucia and her relatives had
successfully managed to overcome the secondary alienation this type of medical care had carved upon them all.
As patches of the conversations we had in some of our first interviews, I remember she frequently mentioned a
sister, who was a year older than she was, and had died some weeks before she was hospitalized. With a lively pace,
Lucia shared moving appreciations about relatives and friends, and cared about their achievements and difficulties.
Memories of her husband and parents shadowed those appreciations. Funnily, when she referred to her father she used
his first name.
One day, as our interview was about to finish, Lucia stated she was upset because many decisions were taken
without her opinion, and she felt a conspiracy of silence building up around her. Based on what I could perceive in her
complaint, I decided to substantially reduce her psychotropic medication, and also, I asked Lucia for permission to let
her relatives know what she had just told me. In her presence, I confessed to her relatives that I personally did not know
what was wrong with Lucia, but that I ruled out the presence of the so called major disorders – both neurologic disorders
(dementia) and psychopathological disorders (psychosis). 2
2 Based on the psychoanalytical reports authored by Maleval or Calligaris – just to name some recent agreement between 2 (two)
well known authors – a clear difference can be made between “hysterical insanity” and “psychosis” proper. The differences between one and
the other are inaccessible if the criteria of the Diagnostic and Statistical Manual of Mental Disorders - DSM-IV-TR are taken into account
because this manual records the delirium -specific manifestations, but does not pay attention to subjectivity. Of course, if the consideration
of each of the subjects presenting these manifestations is included – in that particular case it will be necessary to establish an intersubject
relationship with each of them - some differences can be made which will be conclusive when two psychopathological entities are to be
differentiated , since even when they include similar manifestations from the point of view of the “look” they remarkably differ in terms of
prognosis and the general therapeutic guidelines. In this sense, an individual who keeps their structure within a psychotic structure does
not make claims like Lucia did so as to defend privacy and get upset about the conspiracy of silence built around them. An individual who
feels like a simple object in the hands of another individual – psychotic structure proper - does not claim, like Lucia did, any abuse, overt or
subtle, of their own being, because at the end of the day, said being does not experience subjectivity as such. In the context of psychosis
proper, delirium is unmanageable – let alone necessary as “restitution”, organizing the world of psychosis. On the other hand, “hysterical
insanity” it is possible to dissolve the interpretation of delirium, simply because delirium is one more manifestation appearing in the psychic
structure of an individual able to get subjectively involved with everything that happens to them, i.e. an individual who is able to recognize
as “their own” something which under certain circumstances might have been left unprotected in mental confusion. Psychosis proper does
not include this possibility of getting involved in delirium ; psychotic patients are unable to experience that they actually think about, wish or
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4. This implied a change in both the diagnosis and treatment approach; Lucia would no longer be the carrier of a
“disorder” but somebody who, in her suffering, embodied a message you are supposed to listen to.
In the interviews that followed, some important facts cropped up immediately, and it was Lucia who went straight
to the point and made reference to central aspects of her conflict.
The following day, she mentioned some important information which would make sense later; it was Renata, her
younger sister, who made the comment. Renata mentioned an old event in the family history she had learnt from one of
the aunts who had raised Lucia. At an early age, Lucia had the courage to face her father when she found out that he
had been hitting his wife – Lucia´s mother – so as to cause a miscarriage, when her mother refused to terminate her
pregnancy. In order to fulfill his objective, Lucia´s father even pushed his wife violently against the walls to cause the
miscarriage. However, Lucia´s words were so emphatic that – she was only 14 at the time – she was so defiant, even
before a group of relatives who pretended not to see what was happening, that finally her father gave up.
Typically violent and authoritarian, on that particular occasion Lucia´s father did not react, and since that
moment, no comments about termination of the pregnancy were ever made again. Finally, Renata was born.
The following day, Lucía and I met, just the two of us alone. At that moment, she was still anxious and
hyperactive. Soon after we started our interview, after some minutes´ silence, Lucia announced that she was going to say
something none of her relatives knew about.
Before speaking up she asked me if I was a catholic, a question I did not answer to encourage her to keep on
speaking instead. I knew very well what she was going to tell me, though.
Some minutes into her speech, Lucia said she preferred to speak in front of one of her daughters, who at that
moment was in the next room. Her daughter came into the office. Lucia said that in the first years of her marriage she
had undergone two abortions with her young husband´s approval. After such a confession she broke down and cried,
and so did her daughter. From then on Lucia´s behavior changed remarkably. She then went on to live days in deep
thought and quiet sadness. Ten days later we agreed on her discharge.
Some time before her discharge she decided to let her other two daughters and her eldest granddaughter know
about her abortions. Soon after her discharge she went back to volunteer work in LALCEC (Argentine League for the
Fight against Cancer); moved to her own apartment, and attended her appointments with me regularly although she lived
far from the capital city.
hate what shapes delirium . The hallucinated voices talk to him and order him what to do. In the case of Lucia, this diagnostic difference had
to be made; she proved to have a full subjective involvement capacity in relation to anything that affected her.
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5. b. Remarkable data gathered during her out-patient appointments
• During her first sessions as an outpatient Lucia decided to report some of the events that had taken place before her
hospitalization, and that in her mind, had contributed to destabilize her.
• As for this purpose, in some of the following sessions, and more than once, she commented that her eldest daughter
probably had an unhappy marriage, for the fact about her husband´s extramarital son had been kept a secret. Lucia
also felt restless about other facts related to that son in law in particular, and she really got upset about his
lukewarm opinions about State Terrorism. From his position – he had attended military academy for some years – it
was a grotesque contradiction for he believed in the same religious principles as Lucia and his own wife.
• About this person, Lucia also said that when she was confused, he had been the only member of the family who had
been rude to her and criticized her for talking nonsense.
• On another occasion she sadly remembered when her son in law got home with lesions on his face because he had
come to blows with the father of one of his son´s schoolmates while they were watching their sons play soccer.
• Issues related to this son in law finally became the hinge of a door that opened towards memories of other distant
events which were very meaningful to her. They were related to the place where the emblematic “Escuela de
Mecánica de la Armada” stood in Buenos Aires. (Translator´s note: “School of Mechanics of the Navy”: notorious for
being one of the places where victims of state terrorism were tortured and killed during the military dictatorship in
Argentina, at present known as “Museo de la Memoria”. Translator´s Note: “Museum of Memories”: this premises,
now turned into a museum, were an illegal center for torture and detention during the military dictatorship).
• When Lucia was about 17 – and already the heroine of the family – she had been asked to encourage and care for
one of her younger aunts, who at the time was married to a despotic man who would not even allow her to go out or
visit her family. Her aunt lived with her husband in an apartment with windows looking onto the street near the
Escuela de Mecánica.
• That woman had a three –year old boy and some health problems, and she was in the third trimester of her second
pregnancy.
• For this reason, every day Lucia used to sit close to a fountain on Libertador Avenue and Gral. Paz Avenue, so that
her aunt might see her, and stealthily go out to say hello to her, or even let her know if she needed something.
• The denoument of this situation was so sad that that aunt finally died after the delivery of her second son. However,
neither Lucia nor the rest of the family ever heard from those “two children” again for the widower moved, and never
contacted his wife´s family again.
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6. • The information described above is considered good enough to support the reflections that follow.
c. Reflections on the subject
We always say more than what we actually say when we make any reference. The words we use to express our
even simplest digressions usually embody traces of other implicit meanings which reappear and emphatically evidence
that there is “something” we have not been able to digest well enough.
Now, it is not only that we “say things” because, in the case of human beings, things can also “say something to
us”. Any given fact may have an implicit meaning depending on our particular interpretation.
Now, considering this capacity to say and decode, we sometimes may end up having a deafening dialogue with
certain things, in which case it is better to create a silent setting so as to be able to hear that implicit meaning.
Going back to Lucía, through many of her comments I could recognize the presence of a recurrent implicit weave
related to the ill-treatment of life from those who are expected to protect it.
Very early in her life she had come to discover violence and the lack of respect for life in her father´s actions. Little
by little and early on she faced the unacceptable, and that feeling grew and grew as she faced similar situations later on
in her life.
Those were the epicenters around which both her suffering and her ideals moved. Her activities related to children
support as a teacher being the daughter of a couple who could not even take good care of their own children – neither
intra nor extrauterine children – may well be considered the result of Lucía´s capacity for sublimation (5), especially in
those moments when the weave of her fears narrowed and triggered another type of reaction.
Treatment led to the recognition of the constrictive impossibility to give sense to the symbolic and fundamental
weave (3) interlaced with certain past events which entwined and produced a thick and heavy fabric. In such a setting
“listening” became essential because the fabric so manufactured became a gag which got loose with delirious shattering.
Like a shepherd attacking his own sheep, her father´s early violent manifestations had interlaced with the
unpunished nightmares of her young aunt who had died after delivery and after having lived like a slave with a
tyrannical man who had never let any of them know about those other two children (her cousins).
It is known that when a thief robs we speak about robbery, but when the thief is that individual expected to
arrest the thieves, we are witnessing the “sinister dimension” (4), a term studied by Freud in German in order to clearly
define the meaning of the phrase.
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7. In the case of Lucía, daily life events with a sinister nature were associated to the events taking place in the
Escuela de Mecánica de la Armada. In this case it was not the guardian of a family hurting others, but the government
authorities themselves who kidnapped, killed and had people going missing.
Some time later, her son-in-law´s hidden story about an extramarital son appeared before her eyes as a never
ending situation without a name, and which never left her.
The presence among her loved ones of a son who “appeared” after a long time was clearly that of a child who was caused
to “disappear” by his own father for a long time.
That led to a long voyage including appointments with the psychiatrist which ended up with Lucía´s hospitalization.
Conspiracy between relatives and physicians at the clinic was one more episode of abuse depicted in this story.
Does the above thus mean that any child who knows about similar facts involving his parents is doomed to
experience the same sequelae ? Absolutely not. The traumatic impact of an event as well as either the presence or
absence or the quality if its manifestations is always singular.To suggest an unequivocal causal relationship sounds
exorbitant. The path to trauma will certainly be clear when an individual discovers, early in life, that the person who gave
them life spares no violent acts jeopardizing life itself.
What magnitude can an emotional commotion reach when minors themselves are compelled to punish their
own parents? Who holds the law illegally in such a situation? Can a 14-year old girl be the agent of the ethical
admonishment her parents claim? What price will she pay for that?
When the lawmaking source in a family fades away, when the individuals expected to fix the rules are precisely
those who break and deny the law, it is clear that any regulating principle is nonexistent, and that setting becomes
unfavorable for the development of a human being who will then be grabbed by recurrent and terrifying concerns. Once
the limit between the allowed and the forbidden is broken, the template guaranteeing any type of covenant is split.
Therefore an individual is left on the alert for any atrocity without the shelter provided by limits, references or rules.
III. REPETITION
Given the situations which had had a traumatic impact on Lucía´s subjectivity, it is easy to understand that
repetition was bound to occur.
A parent´s mistakes or the parents´ mistakes, either one or the other, depending on their tenor, may well
determine the repetition of said mistakes by children who desperately need to meet their parents. In fact, fulfilling the
same acts bring those who fulfill said acts together. In an unsuccessful attempt to re-place her father in his institutional
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8. role, Lucía had undergone abortion twice in order to re-place her father where he belonged, thus covering her unbearable
mistakes with other mistakes she herself was responsible for.
Far from achieving quietness by re-placing her father, Lucía found herself in a situation similar to that of a thief
who robs in order to understand and forgive a thief.
Based on the above, a meaningful and confusing repetition is created: “we were two kids back then “ (page 1);
“neither Lucía nor the rest of the family ever heard of those two kids (page 7) so the two abortions (page 5) placed Lucía in
an ambigious position because unconsciously she hesitated about her own position; she experienced tremendous
anxiety for she did not know whether she was one more of the persons missing or one of those who bullied people about.
The silence conspiracy between relatives and physicians at the clinic was the last abuse that placed her in the
position of those who have no voice or right to make any decisions about themselves. Lucía in her loneliness and tragedy
was once again the defendant and the heroine trying to settle a conflict by putting the blame on herself.
IV. COROLLARY
Many years have gone by since I first met Lucía in that room in the psychiatric clinic in early 2005. To date, she
has not exhibited any psychiatric disorders. She does not need psychotropic medication, she is well informed, active, and
leads a fairly active family and social life. Neither the person we called Lucía nor her daughter objected to the publishing
of this story.
The material in this paper fits in the clinical categorization reported and published by Dr. Carmen Gomez Lavin
in the international medical literature. Cfr, MEDLINE “Diagnostic Categorization of Post-Abortion Syndrome”; 2005 (14) –.
The years passed between the triggering events and the sequelae of said events – as pointed out by Dr. Wanda
Franz (15) – put Lucía in a “Late Post- Abortion Syndrome”.
BIBLIOGRAPHY
1. Maleval, J. “Locuras Histéricas y Psicósis Disociativas” Paidós, Buenos Aires, 1999.
2. Calligaris, C. “Hacia un estudio diferencial en la Clínica de las Psicósis” Nueva Visión, Buenos Aires, 1997.
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Aires 1988.
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9. 8. Freud, S.: Obras completas. Tomo XVII. Amorrortu Editores, Buenos Aires 1988.
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10. Lacan, J. “Función y campo de la palabra en Psicoanálisis” Escritos I. Siglo XXI Eds. Argentina, 1988. Pág. 269.
11. Lacan, J. “El Seminario de Jacques Lacan”, Libro V. Clase del 15 de enero de 1958. Paidos, Buenos Aires-Barcelona-México,
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13. Luypen,W. “Fenomenología del Derecho Natural” Ediciones Carlos Lohlé. Buenos Aires, 1969.
14. Gómez Lavín C, Zapata García R. “Diagnostic categorization of post-abortion syndrome”. Actas Esp Psiquiatr. 2005 Jul-Aug;33(4):267-
72. PMID:15999304 [PubMed - indexed for MEDLINE]
15. Wanda Franz, et al.: “Differential Impact of Abortion on Adolescents and Adults”. In: Adolescence 27 (1992) S. 161-172.
Translated by Claudia Tarazona, Visit www.claudiatarazona.com.ar
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10. 8. Freud, S.: Obras completas. Tomo XVII. Amorrortu Editores, Buenos Aires 1988.
9. Freud, S.: Obras completas. Tomo XVIII. Amorrortu Editores, Buenos Aires, 1988.
10. Lacan, J. “Función y campo de la palabra en Psicoanálisis” Escritos I. Siglo XXI Eds. Argentina, 1988. Pág. 269.
11. Lacan, J. “El Seminario de Jacques Lacan”, Libro V. Clase del 15 de enero de 1958. Paidos, Buenos Aires-Barcelona-México,
1999. Pág. 171.
12. Freud, S.: Obras completas. Tomo XII. Amorrortu Editores. Buenos Aires 1988.
13. Luypen,W. “Fenomenología del Derecho Natural” Ediciones Carlos Lohlé. Buenos Aires, 1969.
14. Gómez Lavín C, Zapata García R. “Diagnostic categorization of post-abortion syndrome”. Actas Esp Psiquiatr. 2005 Jul-Aug;33(4):267-
72. PMID:15999304 [PubMed - indexed for MEDLINE]
15. Wanda Franz, et al.: “Differential Impact of Abortion on Adolescents and Adults”. In: Adolescence 27 (1992) S. 161-172.
Translated by Claudia Tarazona, Visit www.claudiatarazona.com.ar
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