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What's Goin' On? Finding Your Voice in the Aftermath of Abuse

By Keith R. Green

May/June 2010

Keith Green Childhood sexual trauma can play out in many different ways. For 19-year-old Jordan, it impeded his ability to confront a cheating boyfriend who was rumored to be HIV-positive. I met Jordan shortly after he'd contracted both syphilis and HIV while in that relationship.

In addition to my role as project director of a multisite pre-exposure prophylaxis (PrEP) study being run through the county hospital here in Chicago, I am also working towards my license as a Clinical Social Worker (LCSW). To do this, I see patients for therapy on Thursday afternoons in the hospital's Adolescent/Young Adult Clinic (AYAC). Because I'm in the clinic just one day out of the week, I've specifically requested to only be referred young people who have symptoms of psychopathology and those who request a male or African American therapist. As you can imagine, there is never a dull moment for me in the clinic.

AYAC is set up in such a way that every young person who walks through the door, regardless of what they come in for, receives both a medical and psychological evaluation. Since we're a part of the county health system, we typically serve the members of the county with the most unmet need.

Jordan was referred to the clinic by Dr. Margo Bell, who is the co-principle investigator of the research study that I work on, as well as one of the two attending physicians in AYAC on Thursdays. She is deeply invested in the health and well-being of young men who have sex with men, and her work within the community has facilitated a linkage to care for many who may not otherwise have had one.

I had a million things going on the day that she introduced me to Jordan, but dropped everything I was doing to meet with him at her request. He'd been diagnosed with both HIV and second-stage syphilis, a co-infection that we often see at the clinic. Jordan was a young man with beautiful skin the color of dark chocolate and a bright, pretty smile that instantly warmed my heart. I could see clearly that, behind his pearly whites, he was hiding a great deal of hurt and pain. We bonded instantly, and he agreed to allow me to conduct a psychological evaluation (although he made it clear later on in the interview that if I had been of any other race/ethnic background his response would not have been so favorable).

His story was one of survival and resiliency. His mother had died when he was a small child. He was raised by his father and spent a great deal of time in the home of his paternal aunt. It was in that space, beginning when he was in kindergarten, while he was changing clothes after school, that Jordan was sexually molested by his father's brother.

I could see the fear and anger in his eyes as he seemed to relive the experience right there in front of me. The abuse had taken place over the course of about six years, and Jordan never spoke a word about it to anyone during that time. His uncle had threatened to kill his father should he do so. Ironically, it was an intense argument between his father and that same uncle that resulted in his father's death. Jordan, unfortunately, had witnessed the entire tragic event.

Although he would later disclose to his sister that he'd been molested by their uncle throughout a great portion of his childhood, Jordan never told anyone else or attempted to confront his perpetrator. In fact, even now, in a time when he admits to needing the support of as much of his family as he could muster, he avoids his aunt's house at all costs because that same uncle still lives there.

In addition to helping him to develop healthy ways of coping with his recent HIV diagnosis, our therapeutic relationship is focused on allowing Jordan a space to unravel and address the array of emotions that he has with respect to being sexually abused as a child, and to understand the connection between those two unfortunate circumstances. By his own account, our relationship is one of the first that he's been in where he feels that he has a voice, and that his voice is actually heard. It is my hope that he will acquire the skills necessary to demand that kind of exchange in future relationships, and to be able to establish healthy support systems with other members of his family he's cut off in order to avoid contact with his uncle. I'm careful not to lead him to believe that this will be an easy task, but I've also assured him that he can have the rest of a healthy lifetime (both physically and mentally) to do so.

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