The Masked AMHP assessing "nature or degree" in the hit Edinburgh Fringe play "How to Survive a Mental Health Tribunal -- Missus"
The following account may contain triggers for self harm.
It’s nearly 10 years since I last had any contact with Eunice, but I still think about her from time to time.
Eunice was, and still is a mystery. I don’t think I ever really did get to the bottom of what was happening with her. I don’t suppose I ever will.
Eunice was in her 50’s. She was married to a man somewhat older than her. He was a bank manager. When he retired, they moved to Charwood, and bought a large house on an upmarket estate.
Her consultant psychiatrist from the area where she had lived wrote a letter of referral to the CMHT. It described her as a “pleasant, polite and deferential lady” with a long history of depression. More unusually, she had consistently recounted a long history of having been physically and emotionally abused by her husband. More than that, she also described a history of having been the victim of systematic physical and sexual abuse by a group of men, including her husband, who would come to her house and abuse her in various unspeakable ritualistic ways. The psychiatrist had never been able to corroborate these stories. He had once invited her husband to come to an appointment, but the husband had not attended.
I conducted an initial
assessment with a female member of the team. Eunice was a tiny, birdlike woman
who had very poor eye contact. She frequently trembled during the assessment,
and often appeared to be in great distress. She recounted a history of
childhood emotional and sexual abuse at the hands of her father. She was an
intelligent woman who went to university and obtained a degree in English
Literature, then met and married her husband and became a housewife and mother
to her son and only child.
It was noticeable that
her arms were covered with a silvery criss-cross of scarring consistent with
many years of self harming with a sharp object. However, when I asked her about
the scarring, she denied that she had ever deliberately self harmed, claiming
instead that these were inflicted by her husband and others during their abuse
of her.
When I came to write up my assessment, I
concluded that “Eunice's overall presentation is consistent with a history of
chronic sexual, physical and emotional abuse as a child, and her accounts of
this abuse, and her beliefs and reactions revealed when discussing it, ring
entirely true. However, her accounts of the sadistic abuse over many years by
what appears to be an organised ring is necessarily very hard to believe. This
is not a description of conventional, if that is the word, "satanic"
or "ritual" abuse.”
Despite my reservations, my approach with
people who reported childhood abuse has always been to believe them unless I
had evidence to the contrary.
I worked with Eunice for over 5 years in
total. Initially, I attempted on a number of occasions to persuade her to allow
me to report her allegations to the police and the Adult Protection Team. She
would never allow me to do that. I explored with her as gently as possible the
nature of the abuse. Some of it involved reports of her husband deliberately
inflicting pain on her, an example being when he allegedly burned her with an
electric iron. She showed me the burn on that occasion.
There were in fact several times when I saw
injuries on her, including what appeared to be rope burns on her wrists and
ankles. On one occasion she told me that she had been taken by car, with a hood
on her head, to somewhere in the countryside, where she had been tied up and
then subjected to a range of appalling ordeals. But she would never let me
intervene.
I continued to persevere with her, trying
to improve her self esteem and assertiveness to the extent that she would
permit me to take action over this apparent abuse.
In one review I noted:
The injuries I have seen on Eunice are
consistent with systematic and organised abuse. However, these injuries could
as easily have been self inflicted as caused by others. There are three
possible explanations for the reported abuse:
1. She is the victim of an organised ring of sadists of whom her husband is a member.
2. She has a longstanding and consistent, but untrue delusion that she is the victim of this abuse, caused by a psychotic state.
3. The accounts of the abuse as an adult are hysterical inventions and all the injuries are self inflicted and consistent with Munchausen's Syndrome, possibly arising as expressions of genuine childhood abuse.
1. She is the victim of an organised ring of sadists of whom her husband is a member.
2. She has a longstanding and consistent, but untrue delusion that she is the victim of this abuse, caused by a psychotic state.
3. The accounts of the abuse as an adult are hysterical inventions and all the injuries are self inflicted and consistent with Munchausen's Syndrome, possibly arising as expressions of genuine childhood abuse.
She will not give me permission to speak to
her husband, and has refused offers to help her leave him and go to a safe
place, saying she is afraid not so much of what they might do to her, but that
they might harm her adult son.
After a couple of years of working with
Eunice, her husband unexpectedly and suddenly died of a heart attack.
Although Eunice expressed considerable
grief, I also saw this as a possible new start for her. Now her husband was
dead, she might be able to forge a new life for herself, free of abuse.
I enlisted the help of a female support
worker from the team, and together we helped her to clear her house of her
husband’s effects. I had secretly hoped to find some corroborating evidence
relating to her husband’s double life, but there was none.
The support worker began to work with
Eunice, and over several months Eunice’s mood appeared to improve. I even
caught her smiling occasionally during my sessions with her.
Then she began to tell us that she was
again receiving visits from the men.
She reported to us that one of them had
left an obscene message on her answering machine. Unfortunately, she had erased
it.
On another occasion, she told us that a
video had been posted through her letter box containing compromising scenes
involving her husband and herself, and a threat to send it to her son. However,
the “visitors” then took it back.
Still working on the basis that what she
told us was true, in spite of some misgivings (why did she always dispose of
the objective evidence), I encouraged her to increase her security, including
having a spyhole installed in her front door, installing a chain, and also
ensuring that her other doors and windows were secure. I even suggested that we
have a CCTV camera installed, but she would not agree to this.
Then one day, when I visited her, I found
her in a state of intense distress. She said that the previous afternoon there
had been a ring on her doorbell. She said that when she opened the door, one of
the men was there. She eventually revealed, over a long period interspersed
with tears and trembling, that he had forced his way in, and had then dragged
her upstairs where he had tied her up and abused her.
She showed me what looked like fresh rope
marks on her wrists and ankles.
I told her that this could not be allowed
to continue, and that I would have to report it to the police.
I arranged for a female police officer to
interview Eunice in the presence of the support worker. She was told that, for
a formal investigation to take place, she would have to make a formal complaint
and have a medical examination. She said that she could not tolerate submitting
to a physical examination, as it would remind her too much of her abuse.
Stalemate.
Eunice continued to give periodic reports
of visits from the men, and accounts of their continuing abuse of her.
Sometimes she would show us injuries – rope burns, bruises.
After a few more months of this, I
discussed the case with a female officer from the local Adult Protection Unit
without telling Eunice. She said she would make some discreet enquiries prior
to any further action. I assumed she meant that she would do some background
police checks on Eunice’s husband. She came back to me, saying that they would
not be able to do anything further without interviewing her.
Eunice reluctantly agreed to this.
I was pleased about this – the Adult
Protection Officer was extremely experienced and might just be able to get
somewhere with Eunice.
She interviewed Eunice on her own, at her
home, coincidentally the day after Eunice had reported yet another “visit” and
with accompanying rope marks on her wrists.
The Officer reported back to me afterwards.
She did not consider that Eunice was being abused in the way she described.
This was on the basis of the content of Eunice’s account, her body language
during the interview, and exaggerated and incongruous reactions to touch, etc. She
also based her conclusions on her experience of interviewing rape victims as
well as people known to have made false allegations.
I decided that I should change focus with
Eunice. I reviewed her Care Plan with her, pointing out that it appeared she
would prefer me to sit and listen rather than try to impose change on her that
she feels unable to achieve. She gave me a list of concerns which I tried to
address, some practical, some emotional. One thing was her car wing mirror,
which was hanging off. I looked at it for her, and was able to fix it easily
and quickly. Eunice appeared delighted in a childlike way by this, even smiling
spontaneously.
For the next few sessions, I became a
handyman, replacing light bulbs that she could not reach, fixing a latch on her
back gate, fixing a leaking tap. While I did this, she sat and talked to me
about her mixed feelings of grief and relief over the death of her husband. I
did not mention the “visitors” and neither did she.
Then one day she abruptly announced that
she was moving. Her son, who lived in another county, was arranging for her to
live in a bungalow nearby to where he lived. He was taking over her house and
was going to let it out.
Within a month, she was packed and gone.
I confess to a sense of relief. She was no
longer my problem.
A few months later, however, I received a
letter from her. She said that she did not know what to do, as the “visitors”
appeared to have tracked her down, and were again entering her house at will
and abusing her in various terrible ways.
I wrote back, telling her that she had to
report it to the police, and should also let her son know.
I never heard from her again.
