Abused women
to share in new
therapy project
A new type of 'talking therapy'
seeks to 'alleviate depression,
get rid of guilt and increase
self-esteem' for 120 isle womenNo longer 'a worthless person' By Helen Altonn
'From hell to hell to hell'
Star-BulletinResearchers are testing a new type of therapy to help battered women who suffer from post-traumatic stress disorder.
They believe these women constitute the largest group of PTSD victims in Hawaii.
Depression, guilt and low self-esteem coupled with shame are major PTSD symptoms, said Dr. Edward Kubany, clinical psychologist at the Pacific Islands Division of the National Center for PTSD in the Veterans Administration.
"We're predicting the symptoms will disappear -- that we will alleviate depression, get rid of guilt and increase self-esteem," he said.
The three-year project is designed to measure the success of "Cognitive Trauma Therapy" on 120 abused women.
Basically, it's "talking therapy" -- encouraging the women to confront their fears and pain and to work through them, according to project therapists.
Kubany is collaborating with Lt. Col. Liz Hill, principal investigator for the project. Hill is assistant chief of the Department of Clinical Investigation and chief of nursing research at Tripler Army Medical Center.
Julie Owens, a family violence victim who runs the SAFETY for Battered Women program through the YWCA, is a co-investigator and therapist. Other therapists are Cindy Iannce-Spencer and Dr. Ken Tremayne. University of Hawaii psychologist Stephen Haynes is a consultant.
The Department of Defense provided $305,000 for the study through the Tri-Service Nursing Program.
"We beat out a lot of tough competition for this money," Hill said. "It's not only a good thing for military women and military family members, but it's a great collaborative research effort to do something about a community problem."
Hill said the therapy being evaluated has potential for widespread use: "We could do it with soldiers coming back from the war, with health care personnel, people coming back from a disaster, relief or peacekeeping missions."
Abused women are being recruited for the project in pairs, with one beginning therapy immediately and the other starting six months later.
Fear, helplessness, horror
A complete trauma history assessment is done in the first session. Clients are assessed when the therapy ends and again in three months, to see if the wait makes a difference in the outcome.Kubany said a nationwide study of Vietnam veterans in 1989 showed 36 percent with high combat exposure had full-blown PTSD, and more than one-third still had it five years later.
"Time does not heal," he said.
"PTSD is the only disorder with a specified cause: really bad things that produce fear, helplessness and horror," Kubany said. Owens said many abused women "are walking around derailed, maybe for the rest of their life, not trusting, afraid of men, being depressed all the time. As shock wears off, confusion and disbelief set in, leading to guilt."
Kubany said guilt is "a horrendous problem" among battered women, who feel they should have foreseen and prevented the abuse. "We have a very structured analysis to get rid of that," he said.
The idea is to change the way the women think so they can change how they feel and, therefore, change their lives, Owens said.
Sessions are held 1 hours twice a week for four weeks. Participants are trained in muscle relaxation -- because high levels of anxiety cause muscle tension -- and they're given homework to practice relaxation and to identify abuse-related issues.
Kubany said "avoidance busting" is a major part of the therapy because battered women avoid places and things that remind them of the violence. "We have them identify all the harmless reminders (of the abuse) that aren't dangerous." For example, he said, "How many battered women look at pictures of the abuser?" A common exercise is to have a woman put the abuser's photo on the refrigerator so she won't be intimidated if she sees him, Kubany said.
One woman who had been abused by a drunken partner would never go to a party where there was alcohol, he said. "So there is not only fear but loss ... a loss of social functions. These are extremely important losses that have to be grieved."
Breaking down guilt
Another woman, who had been raped in a back yard, wouldn't go to barbecues or anything in a back yard, Owens said."She missed out on so much. We had her go into a back yard because a back yard is not dangerous. ... Whatever the loss and guilt issues are, we work on dismantling each one."
A psychologist for more than 20 years with the Veterans Administration, Kubany has had a small private practice for about five years working almost exclusively with battered women.
He taught courses on PTSD in 1988-89 at UH. Few professionals were familiar with it then, even though it had been identified as a psychiatric disorder in 1980, he said.
He began looking for battered women to talk to while teaching a graduate psychology class on PTSD in 1991. Owens said she told him her story and how she overcame PTSD by learning to defend herself.
"We see PTSD as a thinking disorder," Kubany said. "How you think affects how you feel. We can't change what happened but we can change your interpretation."
He said they "break guilt down into parts" so the women realize what happened wasn't foreseeable or preventable, and they weren't responsible.
"I hate to be overly optimistic, but of eight people I have had so far, we removed the PTSD diagnosis after therapy for seven," he said.
He said the women are given an enormous amount of information. The most common response in the feedback is, "I learned so much," he said.
"It's very intense," Owens said. "It's not like going to a therapist and talking and leaving. ... They have to work on their specific symptoms and problems.
"It's incredible that they're not homicidal maniacs because of the things they've been through," she added. "Literally, physical and psychological torture are the order of the day."
The women are taught how to overcome mistrust, how to identify potential abusers and avoid being revictimized, he said.
The ability to think is impaired for abused women, so they're given decision-making exercises, Kubany said. "We want women to act in what's in their best interest."
He said veterans with PTSD express anger, but trauma-related anger is relatively minor among women.
"They're abused when they stand up for their rights, so they stuff it down and avoid conflict," he said. "If they do that, how can they stand up for their rights?"
Women with post traumatic stress disorder related to abuse by a partner are being sought for the Cognitive Trauma Therapy project. Free therapy will be provided in eight sessions. For more information, call 566-1554. Help for trauma
No longer ‘a
worthless person’Confronting her issues
by Helen Altonn
leads daughter to success
Star-Bulletin
Christie Corpuz says she was molested as a child and had a succession of abusive relationships starting when she was 12 years old."There was no one to say or teach me differently," she said. "Anyone in a different lifestyle, they were not normal to me."
She was involved with four abusive men, she said, noting she met the first one through her church. "The pastor knew and did nothing. That's why I'm not worshipping there anymore."
She didn't try to get away from any of her partners, who eventually left her. "When you try and run, you get it even worse than before if they catch you, and they do catch you."
She became pregnant at 17 and didn't tell her mother. "I didn't think she could handle it. She couldn't protect herself. How could she protect me?"
When her parents divorced, her mother was ordered to go to a counseling program with the children, Corpuz said. "Everything started opening up. I was 19 or 20."
She met Julie Owens, an abuse victim and therapist with the PTSD therapy program, who was working with battered women.
Owens encouraged her to see Dr. Edward S. Kubany in the trauma therapy project.
"She's a fabulous person, smart and articulate. She's a great mother. She has everything going for her, but her life was stalled badly," Owens said.
"I was really scared about addressing any issue," said Corpuz, who began seeing Kubany in March before the project began officially. "I was able to bottle it up. I thought I was all right with it. Dr. Kubany opened my eyes to a lot of stuff I was doing that I didn't know I was doing."
She said she avoided 10 or more things associated with her abusive partners, including four different colognes and the beach. "My first boyfriend had done a lot of violating on the beach because he lived in Waianae."
She has since gone to the beach several times with a companion.
Her worst fears were related to Old Spice men's cologne, she said.
"Dr. Kubany told me to just try to sniff it, to buy a bottle and keep it in my room. ... My heart started beating fast. I started sweating, just thinking, 'Oh my God, he wants me to buy a bottle.'"
Her mother got a bottle for her, she said. With the top still on, she smelled it and started getting dizzy, she said.
"I just had to keep telling myself it's just cologne; it can't hurt me. It's a nasty smell, but it doesn't affect me like it used to."
Corpuz said she had major guilt feelings because of her abusive partners. "I felt guilty about loving them and staying with them, making excuses for them. ... I always thought there was something wrong with me because I kept getting involved with these idiots."
She also had a "horrible traumatic experience" when she was raped by a neighbor, she said.
She said she's not ready for a relationship anytime soon, but she knows the signs now of a potential abuser: "if he doesn't like it when I try to bring out my opinions, or if he doesn't respect my opinions, if he tries to force intimacy too fast, if he doesn't respect my privacy and personal space."
Corpuz said she's happy just to be with her children, 7 and 3 years old, and work toward becoming a high school counselor. "It was so many years all the things were belted into my head -- 'I'm worthless; I'm a slut,' " she said. "I have to use the tools (from therapy) the rest of my life. I'm a worthy person. I don't deserve to be hit."
Gloria Riveira said she endured an abusive childhood on the Big Island knowing "once I was 18, I would be out of that house." ‘It went from hell
to hell to hell’
for momOne week after high school graduation, she left for Oahu and cut herself off from all of her family except one brother, she said. She has three brothers and two sisters.
"I grew up hating my mom because she was the abuser," Riveira said. "My dad abused the family as a whole and physically abused my mom on a continuous basis. Everybody was abused."
She also was molested by an uncle on Oahu when she was 17, she said.
"I grew up very unloved. I felt so worthless that I don't deserve even to have the breath of life because if my own parents don't love me, who's going to love me?"
After moving to Oahu, she worked at Fort DeRussy, went to an airline school, then got a job as a tour escort and met her ex-husband, a tour driver.
"If I knew the red flags I know now ... Within a week he announced to all the tourists on the bus that we will be married."
They were married for 20 years and had three children. "He was very abusive right away," she said. "Within the first week he was calling me all kinds of names. He started hitting me within a month with such rage. He choked me until I'd pass out."
She ran away once and stayed all day at Ala Moana Beach Park. When she returned home, "He said all the things I wanted to hear, that he loved me," she said.
"He told me a number of times, 'If you ever leave me, I'll kill you.'
"He clicked a gun in my face one time and said, 'If I don't have you, no one else will.' He pulled a knife on me in front of my children." Riveira said she thought of killing herself or him. "But what was going to happen to my children?"
She called a shelter once but was frightened when a man answered the phone, she said. "I felt I was in Catch-22."
She said her husband "fooled around. He cleaned me out. He pretty much abandoned the family."
Still, her pastor told her that "a bad father is better than no father" and that she should try to "win him back," she said. "So it went from hell to hell to hell."
She said they were evicted twice. "I was trying to support three kids. I worked for the state but it was not enough. He wasn't providing anything. I was still hanging onto the marriage, trying to win him back."
She learned he had a mistress, and still she "didn't want to be the bad guy to file divorce and take the kids away from the father."
Then her son told her: "He's not going to change. You've got to do something."
"I had permission from the kids," she said. "I told him to stay the hell away."
She was divorced seven years ago. The court sent her and the children to counseling because of allegations of abuse. But she continued to have PTSD, she said.
Since joining the trauma therapy program, she said, "Dr. Kubany helped me with a lot of my thinking and avoidance issues."
She had a picture of her ex-husband with two grandchildren and had put a sticker over his face. "He told me to take the sticker off. ... This picture no longer can hurt me."
She said she asked her youngest son to invite his father to his high school graduation. "Before therapy I wouldn't have done it. ... I had no butterflies whatever. He was no longer a threat to me.
"I have never felt more complete," she said. "I have God, my health, my children and my life. And I have just finished building my own house with my children."
Riveira said she has asthma, which is aggravated by emotional anxiety, and the therapy "has helped me be more healthy. It has given me a healthier outlook on life.
"It's a piece of gold I'm going to keep in my heart. ... I'm no longer a worthless person. I'm a person of value."
