I want to live

processing abuse with the therapies of Stettbacher and Jenson


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Appendix 2: Stettbacher, Jenson and scientific research

The scientific foundation of the four steps

What can be concluded from my story? Konrad Stettbacher¹ and Jean Jenson² are not well-known names among psychologists — was I really cured by their methods? Is there any proof that their therapies work? Can I advise people to do these therapies or not? What do experts think to be good treatment for people suffering from a history of childhood sexual abuse? And what kind of problems do these people have? Was I an exception, with the kind of symptoms that were troubling me?

While studying Clinical Psychology at the Open University in The Netherlands, I started doing research into treatment of people with childhood sexual abuse. For this research, I have read a lot of scientific articles, and in those articles, I have looked for answers to these questions.

What are the consequences of childhood sexual abuse?

People with a history of childhood sexual abuse who seek help, often have symptoms that have been described in the diagnosis of complex posttraumatic stress disorder (CPTSD)³. This diagnosis is not part of the DSM-IV⁴ (the list of psychiatric disorders as used by psychiatrists and psychologists around the world) but has been introduced by the famous American psychiatrist Judith Lewis Herman³ as the diagnosis for people suffering from chronic trauma.

The DSM-IV4 does contain the diagnosis of posttraumatic stress disorder (PTSD), describing symptoms that emerge from a single traumatic experience in adulthood, like a traffic accident or rape. People suffering from PTSD are easily startled, have repeated, disturbing re-livings of their stressful experience, and try to avoid their memories. People who have had several traumatic experiences over a longer period as a child, like sexual or physical abuse, get more problems than just PTSD. Apart from PTSD symptoms, they also suffer from symptoms like self-harming and suicidal behavior, physical symptoms, social problems, dissociative symptoms (the generic term for experiences like not feeling real, “living in a fog”, “stepping out of your body” and memory problems) and feelings of loneliness, hopelessness, helplessness, shame and guilt.³ It is also known that their memories can be “different” from normal memories, for example physical re-livings.⁵ Another term to describe the results of chronic traumatic experiences is “disorders of extreme stress not otherwise specified” (DESNOS).⁶ The diagnosis DESNOS has the same symptoms as CPTSD — symptoms that are well recognizable in my story.

It is not known how many people suffer from CPTSD or DESNOS, since they are often diagnosed with another disorder, like PTSD, borderline personality disorder or dissociative identity disorder.³ Yet, the data tells us that a considerable part of the psychiatric patients do have a history of childhood sexual abuse: research shows that 36 to 70% of the female psychiatric patients has been sexually abused as a child.⁷Often they don’t tell about the abuse of their own accord during treatment, sometimes because they don’t see a relation between their problems and their history, sometimes because they don’t see their memories as memories or don’t remember, sometimes because they have bad experiences with talking about their history.⁸So, I wasn’t the only psychiatric patient with such a history, and not the only one who was silent about this.

What works and what doesn’t?

The first thing that is obvious from scientific research, is that “doing nothing” doesn’t bring any improvement when people suffer from CPTSD — people on a waiting list don’t show any progress.⁹ People who have problems because of childhood sexual abuse do not recover spontaneously, so my recovery in the years that I did self-help therapy probably wasn’t spontaneous either, but it has been the therapy that has helped me.

The next thing that emerges from scientific research is that the contact with the therapist is seen as a crucial part of the therapy.¹⁰ As I did my therapy totally alone, without a therapist, my progress is most probably the result of the therapy method that I used.

There are many therapy methods for people suffering from childhood sexual abuse. Exposure¹¹, EMDR¹², cognitive processing therapy¹³, John Briere’s self-trauma therapy¹⁴ and cognitive processing therapy working with “hot cognitions”,¹⁵ are all mentioned in scientific articles as good treatment for traumatized people. Some people do improve a lot using these methods, others a bit, and some don’t show any progress.¹⁶ For many people, the tested methods are not sufficient, but these people often got only six or eight sessions during research, while people normally do therapy much longer.¹⁷

What are these methods, the therapy methods that are described in scientific literature? Are there similarities between these methods and the therapy methods of Stettbacher and Jenson, or do Stettbacher and Jenson have a totally different approach? Which advantages and disadvantages do the various methods have?

Exposure and EMDR

Exposure involves giving words to memories and feelings — comparable with step 1 and 2 from Stettbacher’s therapy, and also part of Jenson’s therapy. The main aim of exposure is the disappearance of fear (extinction). This fear is aroused by telling in detailed about the memories during an exposure session, and it vanishes when the client stays in the fearful memory for a longer period (30-45 minutes) while using relaxation of muscles and breathing retraining.¹¹ For survivors of childhood sexual abuse, gradual exposure (systematic desensitization) is preferred: clients establish a hierarchy of fear-inducing stimuli and start with recalling the least distressing memory. Then, during several exposure sessions, the client processes increasingly fear-inducing memories or aspects of memories.¹⁸ A difference with Stettbacher’s and Jenson’s therapy is that, before the exposure session starts, the story that is going to be told is recorded precisely, and during the sessions the therapist will guide the client through her memories by asking questions.

Therefore, exposure requires a clear, accessible history. For people who have little awareness of what happened to them, maybe this therapy method can’t be used.

When working with EMDR, people also describe their feared memories, but they are more free to tell what comes to mind than when using exposure. They can determine for themselves which memory they will talk about, and may go from one memory to another,¹² like in the therapy methods of Stettbacher and Jenson. Using EMDR, people are being distracted while feeling intense emotions, for example by following the therapist’s finger with their eyes as it passes back and forth in front of their face. Apparently, having to use working memory while reliving traumatic experiences seems to be what makes EMDR work.¹⁹ This also happened when I did my self-help therapy, since I had to guide myself through the four steps.

Reliving traumatic memories, as happens during exposure and EMDR, has been shown to be effective in treating acute adult traumas: PTSD symptoms diminish this way.²⁰ Not all researchers think this kind of therapy is suitable for people suffering from childhood sexual abuse, having more and more difficult problems. Some people warn that symptoms of complex posttraumatic stress disorder can be exacerbated by exposure,²¹ and some therapists choose present-centered treatment that avoids trauma focus. ²² However, several researchers conclude that clinicians are unjustly afraid of using exposure therapy when they treat patients suffering from PTSS or childhood sexual abuse.²³The long-term benefits of exposure and EMDR are superior to those found in present-centered treatment.²⁴

Because of the risk of worsening symptoms, exposure treatment for people with complex posttraumatic stress disorder is often organized into phases, where phase 1 comprises taking care of a more or less safe and stable personal environment, phase 2 consisting of the processing of memories by exposure or EMDR, and phase 3 the building of a new life with regards to social contacts and jobs.²⁵SStettbacher and Jenson also advise not to start therapy in a situation that is instable or not safe,²⁶ and to avoid sudden, major changes in one’s life (job, relationship etc.) when processing memories.2

Some people say it’s not a good idea to postpone processing memories until the second phase of therapy, since it’s the processing of traumatic experiences that brings the desired stability.²⁷Looking at myself, I think I would never have been admitted to the second phase, considering the limited therapeutic treatment offered in the first phase.²⁵ Without processing memories, I most probably would not have reached the required level of dealing with my feelings without regressing into maladaptive behavior such as self-harm, suicidality or dissociation — although I can never say for sure, not having done this therapy.

An important difference between exposure and EMDR on one hand and my self-help therapy on the other hand, is the fourth step: articulating needs. This fourth step is missing in exposure and in EMDR. I noticed that this step of telling what I needed, has helped me to reach a feeling of relaxation. The third step (thoughts) is part of exposure and EMDR, but not in the systematic way that Stettbacher’s therapy presents this. It was this step that led to rapid improvement when I first worked with Stettbacher’s four steps.

Another difference is that exposure and EMDR only take place in sessions with a therapist, whereas Stettbacher’s and Jenson’s therapy methods can be provided in two ways: as sessions with a therapist, or as self-help that a client can use at home, at moments when the past is disturbing the present. I myself noticed that this offered me more useful therapy time (as I didn’t have to wait until a next appointment but could do therapy at home), and that this made my therapy more efficient (as I didn’t have to search for old feelings in a session, they were just there already). But most of all, this way of working gave me a tool to handle my daily problems — I was no longer at the mercy of recurring panic and fear, and emergency situations didn’t get out of hand anymore. The sense of control that the four steps offered me was extremely important when I started to realize that my “other world” really happened: I doubt if I would have made it without the four steps as a tool to handle my feelings. Treatment with exposure or EMDR wouldn’t have provided me with such a tool, and that would have been a disadvantage for me.

Cognitive Processing Therapy

In scientific research, it has been remarked that exposure does indeed help against fear, but that besides fear other feelings and thoughts also play an important role in traumatic memories, such as shame, guilt, anger, helplessness, humiliation and disgust.²⁸ Unlike fear, these feelings and thoughts don’t vanish when reliving them. Staying in them for a longer period, like happens during exposure, can be counterproductive: the feelings can be strengthened this way.²⁹ The advice is to process these feelings and thoughts through cognitive processing therapy (CPT).¹³

In cognitive processing therapy, three aspects of a memory are under discussion: the events that took place, the thoughts that came up, and the feelings of the victim that can be expressed in the therapy¹³ — equivalent to the first three steps from Stettbacher. In CPT, emphasis is put on what is the third step in Stettbacher’s therapy: becoming aware of, and changing your thoughts about the traumatic experience. The client learns to challenge beliefs and assumptions through Socratic questioning, like unjust feelings of guilt about what happened.¹³ Cognitive restructuring also takes place during EMDR, but mostly spontaneously from within the client and not by logical reasoning.³⁰ Unlike exposure, CPT is advised in the first phase of therapy,³¹ since it can help people to become more stable. That has happened with me, too: when I started doing self-help with Stettbacher’s therapy, it was this third step that brought immediate progress.

Some authors point out that ideas that are believed only rationally (“cold cognitions”) bring little change, while ideas that are deeply felt (“hot cognitions”) do bring change. They argue for another way of cognitive processing therapy, in which the new thought is inserted into the traumatic memory, and they advise to use for that the moments when memories are triggered,¹⁵ much like Stettbacher and Jenson use these moments.

Differences between CPT and Stettbacher’s four steps are the fourth step being absent from CPT, and the order of the steps. “Perceiving, thinking, feeling” in CPT is in Stettbacher’s therapy “perceiving, feeling, thinking”. The latter ordering seems to me the better one, since perceiving immediately leads to feelings that demand attention. Moreover, the feelings disappear during the step “thinking” (changing the meaning of the traumatic experience). It doesn’t seem a good idea to bring up the feelings again after that, since the goal of the therapy is to get rid of them.

Herman and Briere

In her book Trauma and Recovery³ , Judith Lewis Herman describes what should be done with traumatic experiences in the therapy: to give words to the traumatic images and the physical sensations, to verbalize the feelings and the meaning of what happened (“why?”, “why me?”, matters of guilt and responsibility and a new interpretation of the traumatic experience), and to take an ethical attitude that supports the dignity and value of the survivor.

This description of what should happen in a therapy corresponds with Stettbacher’s four steps. Herman doesn’t carry this through as systematically as Stettbacher and Jenson do (who stimulate clients to process memories on a daily basis), and Herman doesn’t give the four steps as a tool for moments when memories are triggered. But what she describes are the same four elements that form Stettbacher’s four steps.

Most similar to Stettbacher’s therapy is John Briere’s self-trauma therapy.¹⁴ In Briere’s therapy, the client learns to take several steps when negative feelings intrude:

1. Identify the triggers that cause flash-backs or intrusive negative feelings (e.g. a thought, or someone being angry at the survivor).

2. Search for a matching memory (e.g. abuse by an angry parent).

3. Identify one’s thoughts (e.g. “he hates me”/”I must have done something wrong”), and realize whether this is realistic from an adult point of view (e.g. “I didn’t deserve this”/”it wasn’t because I did something wrong but because he was drunk/was angry with my mother”). Cognitions are not labeled as “irrational”: they were logical when the trauma occurred. Now, looking back, it is possible to give another meaning to the traumatic experience. Also, there must be a disparity between the contents of the traumatic memory (danger) and the client’s experience of the current environment (safe).

4. Describe and express feelings (e.g. anger, fear, sadness).

Briere’s model holds that self-trauma therapy reflects the survivor’s own adaptive attempts to process memories by spontaneous re-livings. This way of working avoids activating more painful memories than can be tolerated. And the resolution of painful memories is likely to slowly reduce the survivor’s overall level of posttraumatic stress and associated dysphoria. As a result, successful ongoing treatment allows the survivor to confront other, increasingly painful memories without exceeding the survivor’s (now greater) self capacities.¹⁴

Briere’s step 1, 2 and 4 are similar to the description of Jenson’s therapy, and all of Briere’s steps are part of Stettbacher’s therapy. But just like CPT, self-trauma therapy uses the less natural order “perceiving, thinking, feeling” instead of “perceiving, feeling, thinking” as it is done in Stettbacher’s therapy. Also, Stettbacher and Jenson emphasize using the therapy method in daily life, more than Briere does, and self-trauma therapy lacks the fourth step. Briere does write that the survivor’s previous and current entitlement to integrity and self-determinism should be reinforced, but this isn’t a step in the therapy, like the fourth step in Stettbacher’s therapy.

Conclusion

The symptoms that troubled me can be recognized clearly in the scientific literature — I surely wasn’t an exception with the problems that I had. Also, I wasn’t the only one with a history of childhood sexual abuse that sought psychiatric help, and not the only one who couldn’t tell about this history.

Nowhere inn scientific literature did I read the names of Stettbacher and Jenson, but their ideas can be substantiated by other therapy methods. Almost all elements of Stettbacher’s and Jenson’s therapy methods have been described in the “official” therapies in scientific articles that describe exposure, EMDR, CPT (including the form that stresses “hot cognitions”), and Briere’s self-trauma therapy. Since these therapies have been proven to work, it is reasonable to suppose that Stettbacher’s and Jenson’s therapies can help to process traumatic childhood experiences.

But I think more can be said about the therapy as I did it. Yes, all elements of my self-help therapy, based on a combination of Stettbacher’s and Jenson’s methods, can be found in scientifically validated therapy methods. But compared to these methods, my self-help therapy was more complete and the elements were more coherent, and were carried through more systematically than any therapy method that I saw in scientific literature. And working this way, I found that it was this completeness that was crucial for my recovery. Learning to identify triggers, searching for a memory that matches my feelings or thoughts, and taking the four steps with this memory: what happened, how I felt, what I thought (then and now) and what I needed. Using only some of these steps, as happens during exposure, EMDR, CPT or self-trauma therapy, couldn’t help me escape from the fear and the pain — but using all the steps could. Only taking all of these steps brought me what I wanted: to be free from the fear and pain. And for that, I needed to take the four steps every day.

Since I wasn’t exceptional in the symptoms that bothered me, I would expect that more people will react in the same, positive way to the therapy. Maybe more people with a complex posttraumatic stress disorder could benefit from a therapy that includes all of these steps.

Therefore, I hope that, in addition to the existing scientific research on parts of the therapy as I did it, research will start on this whole therapy method. I hope that more psychologists and psychiatrists will be educated to help people with a history of childhood abuse, to help them process their memories, so no one will have to do a therapy on her own, like I did. Most of all, this way I hope victims will get a better life.

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Appendix 3: The Stettbacher-Miller controversy (December 1996-December 1997)

At the end of December 1996 and in the first months of 1997 I am overwhelmed by the images and feelings that I now take seriously for the first time — the abuse by my father. But in this period there is something else that for several months dominates my thoughts and feelings, too. To my astonishment I find out that Alice Miller doesn’t support Konrad Stettbacher’s therapy anymore.

When I find out this, I am scared. I am scared that this means that the therapy that I am doing will not have good results in the end. And I am scared to do this therapy without the support of Alice Miller. Until now, her support has been crucial for me in my self-help therapy. And even long before I started self-help therapy, Alice Miller was my guide. Her books meant so much to me, they kept me on my feet all those years that I was dealing with bad therapies. Losing her feels like a frightening loss. Also, I feel betrayed and abandoned.

This information from and about Alice Miller I find on the Internet, when I am looking for the story that Stettbacher sent me in a German translation — the story by Gerald, an American who wrote about his first fifteen months of self-help therapy and published it on the Internet. I want to read this story in English, but for a long time, I can’t find the time and energy to look for it. But in December 1996, even though I am overwhelmed by memories and strong feelings of the abuse by my father, I find the energy, time and courage to do this. I go to the library one evening — it’s not yet common for people to have Internet at home, I do not even have a computer — where someone helps me to find the story and print it.

To my astonishment I find a note from the “editor” under the preface, that tells that Alice Miller recently rejected Stettbacher’s therapy totally. The note refers to her Communication To My Readers. I look for this Communication and expect that this will bring clarity why Alice Miller set this remarkable step. But in the Communication Alice Miller doesn’t mention any reason why she does reject Stettbacher’s therapy. She doesn’t mention anything wrong with the four steps. She doesn’t even mention the four steps at all.

The things that Alice Miller writes in her Communication seem weird, illogical and irrelevant to me, and I can’t see them as a valid reason for her change of mind. She writes very sharply, negatively and emotionally, but why doesn’t become clear. Nevertheless, I become upset by it.

I feel uncertain, scared and confused. But I realize that these feelings are “old”. And I also realize that I have felt panic before, because of what Alice Miller wrote, and I survived that as well. I have to go my own way, looking critically at what I do and whether other people, including Alice Miller, can add useful things to that. But in the first place, I need to trust my own perception and experience. And those tell me that Stettbacher’s and Jenson’s therapies until now have been the only therapies that worked for me. And not only that: they worked very well. My own experiences do not tell me anything about these therapies being wrong or harmful.

In her Communication Alice Miller blames Stettbacher that 15.000 people have asked him for help — and of course he can’t help them all. But why does she blame him for that? It think it is perfectly understandable that so many people asked him. After all, Alice Miller strongly recommended his therapy as the only existing good therapy. So it was to be expected that people would ask him for a therapist. Some people may have done so before even trying self-help therapy, others may have asked him because they didn’t know how to continue self-help. Why does she blame Stettbacher for this? That seems senseless to me. It is the logical consequence of her own behavior. Maybe she herself is the one to blame for that…

Besides, is this such a disaster? I myself asked Stettbacher for a therapist, too, but then I could continue self-help therapy because he sent me useful information about the therapy. That could be the case with many more of those 15.000 people on Stettbacher’s waiting list. I feel that Alice Miller makes this fact sound far too tragic, as if these people are all totally desperate and on death’s doorstep. Why doesn’t it come to her mind that at least a part of those people are fine, thanks to some extra information and Jenson’s book? This seems to confirm the impression she made with the new edition of her The Drama of the Gifted Child in which she seems to think that no one has managed to do this self-help therapy, except herself. But that is not true, and with this false information, she makes people needlessly scared.

It would have made more sense if she had provided some extra information, to help and support people, instead of rejecting this therapy. It would have made more sense if she had tried to find out what exactly were the problems people struggled with when doing this therapy, and how to solve them. Why does she react so inadequately? The reasons she gives in The Drama for herself having success with self-help and “other people” failing, namely her insight in the subject gained by writing her books and the painting she did, point to the need for more information for people doing self-help, instead of rejecting the therapy. (The other reason she gives, namely that she was very motivated to discover her childhood history, I leave out of consideration, I find this a weird remark that seems to suggest that she was and other people were not motivated. This is certainly not true.)

Also, she writes that she found out that Stettbacher didn’t have a degree as a psychologist. I am not impressed by this fact, I can imagine it very well. I remember how incompetent the psychologists and psychiatrists were who treated me, and I find the proper certificate not a good reference, let alone a criterion to be a good therapist. In the past, Alice Miller thought the same way about this, I remember from her books. And suddenly she doesn’t. She now writes that being trained as a “psychologist or psychoanalyst” is necessary to be a therapist. I am perplexed, how can she write this? I think she is totally wrong, as she herself wrote, too, in the past. Before, she wrote very clearly that a training as a psychoanalyst learns people to treat patients in the wrong way. Now in her Communication she writes that this education “doesn’t guarantee that therapists don’t abuse patients (…)”. I would say: this educations is a guarantee that therapists abuse patients. My own experiences with psychoanalysts are a painful example of that. I was almost killed by these people, exactly the way Alice Miller describes in her books. What the hell is going on with Alice Miller to suddenly forget what she knew before? Is she scared for her reputation when someone she widely recommended turns out not to have the proper certificates? I think this is a childhood feeling that she should acknowledge and deal with in the therapy, in order to find adult solutions for the problem (if there is a problem at all). Or is there another explanation for Miller’s behavior? Then what is the matter with her?

Miller writes that she found out that primal therapy does not have lasting results, and that catharsis brings only temporary relief and no cure. But Stettbacher’s therapy is not primal therapy and is not based on catharsis, so why does she use this as an argument to reject the four steps? She writes that she found out that primal therapy makes people addicted to pain. Yes, I experienced that myself. That is precisely the difference between primal therapy and the four steps — this addiction indeed happens when one does primal therapy, and it doesn’t happen when one uses Stettbacher’s four steps. At least, that is my experience and it seems to me that one can logically conclude that from the differences between those therapies. And she writes that she became aware that maybe it isn’t good to totally go back to a regressive state, like what happens in primal therapy. This is also not new to me, and this also is an important difference between primal therapy and the four steps as I experienced them. When I did primal therapy, I drowned in old pain, I was once again a powerless, desperate, “blind” child, I was only repeating the old misery. This way, my symptoms worsened. The four steps make me realize that indeed I am experiencing memories but at the same time I still am an adult. The four steps give me the tools to handle what is happening with me, and to take care that all aspects of what happened to me in the past are processed: what happened, how I felt, why it happened and what should have happened. This forces me to realize that there is a present and prevents me from being stuck in experiencing old pain and fear.

Just experiencing old pain and fear is endless and harmful; Alice Miller is totally right with that. And at the same time she seems confused since she doesn’t see the difference anymore between primal therapy and doing therapy with the four steps. Stettbacher’s therapy has good results because it doesn’t have the disadvantages of primal therapy. In her book Banned Knowledge Alice Miller was still aware of the differences between the therapies. Why doesn’t Alice Miller know this anymore? Why does she suddenly think the four steps are primal therapy?

It is clear that Alice Miller doesn’t criticize the content of the four steps and that therefore she doesn’t give any reliable reasons not to use the four steps. She only gives arguments that do not concern content and that don’t even have anything to do with the four steps. She does write in an exaggerated, fierce and emotional way. Whatever her feelings and motives may be, it seems they have to do with herself and not with the therapy of the four steps. She writes about things that don’t have anything to do with the subject — to prove something that has an enormous emotional weight for her and in which she seems to have personal interest. As it is clear to me that in her Communication she doesn’t give any reliable arguments concerning content, I decide I can continue my self-help therapy.

Nevertheless, Miller’s rejection of Stettbacher’s therapy affects me strongly, and I still feel a lot of fear and confusion. Fortunately, in the story of Gerald’s self-help therapy, he writes that he is still enthusiastic about this self-help method, five years after he started doing it. This helps me, it gives me courage and hope and support during all this confusion and fear.

There is one thing that really frightens me in what Alice Miller writes: she writes that in 1978 a patient of Stettbacher accused him of sexual abuse. But since Alice Miller doesn’t write more about it than this single remark, it is not really clear. A possibility that comes to my mind is that this woman had the same realistic re-experiences as I had. I’ve had several times when only the absolute certain fact that I was alone at home with all the doors locked could convince me that I was not being abused here and now. If I had been in a therapy room with a therapist, and even more if this had been a darkened room, I am not sure what my conclusions would have been. But Miller’s writings don’t give any indication whether this abuse in 1978 really happened, or that this woman had experiences similar to mine during therapy. And since this subject brings up a lot in me, I decide to let it rest until I will get more clarity about it.

The day before Christmas 1996 I go to the library again and write a long letter to John Speyrer’s Primal Psychotherapy Page (where I found Miller’s Communication). In my letter I tell about my experiences with Stettbacher’s and Jenson’s self-help therapy until then, what it brought me, how I did it, and what I did wrong. Also, in this letter I question and criticize Alice Miller’s Communication. I find it frightening to write this letter and it is hard work for me, but it also helps me, to tell someone about my experiences, to “tell” my feelings and thoughts. It is a relief to put it onto “paper” and send it. Things become more clear to me this way and it gives me some rest.

I ask John Speyrer to send me the appendix to Miller’s Communication. Two weeks later, I find it in my mailbox. I am hard hit. The appendix is a part of the interview with the woman who accused Stettbacher twenty years ago. This interview was published in Der Bund in 1995. The woman, called U. Sch., tells about the abuse during her therapy. Now that I read this, I feel ashamed that I thought that maybe it did not really happen. I do not have any doubt anymore that her story is true. I also feel totally overwhelmed and a lot of old fear and pain is brought up — it causes me many sleepless nights. I am speechless and upset. How could Stettbacher do this? It is horrible what U. Sch. describes. She tells that he sexually abused her, threatened her not to talk about it and told her no one would believe her if she would talk about it. How could he do this? I believe her and I can’t understand. This is really, really bad.

In court, Stettbacher had been found innocent, but I am not impressed by that. Sexual abuse is hard to verify. And when it is just the word of one person against the word of another, there is little chance that the perpetrator will be sentenced. So many abused women have not found justice in court because evidence and witnesses were lacking. I believe U. Sch. and I find it really terrible what happened to her.

Even if Stettbacher believed himself that there had been a love affair between him and U. Sch., as he told in court according to the interview, he should never have had sexual contact with her. He should have stopped himself. Such a relationship with a patient is never allowed, and I think this is always abuse. I can’t imagine that he really thought he was having a love affair with her.

Can a therapy method that is designed by someone who abused one or maybe even more patients, be good? Should I continue the therapy I am doing? My initial feelings are I can’t continue, this therapy can’t be right. It has been contaminated. But when I look carefully at the self-help method, I can’t find anything wrong in it, I can’t find any abuse and no manipulation. I don’t have anything else than positive experiences with Stettbacher’s therapy. It is the first therapy that has really helped me and the first therapy without hidden abuse or manipulation. I don’t understand that the one who designed and described this could abuse his patients. His book is written with so much integrity and in his words is such empathy with abused people — how could he abuse people himself? I really don’t get it, I don’t understand it. Why didn’t Stettbacher pull up himself before he started the abuse? After all, he himself writes in his book that strong longings and urgent desires are a reliable track to someones past. Why didn’t he use his therapy at that moment? I don’t understand and feel very disappointed in him. U. Sch.’s story convinces me that this really happened, although Stettbacher has been found innocent, and I feel very sorry for her. But however inconceivable it seems after reading U.’s story, the four steps still seem a good therapy method to me.

There is more that I feel puzzled about: in this entire affair there is the extreme contrast between U. Sch.’s story and Mariella Mehr’s story, as she described in her book steinzeit. As far as I know, both U. Sch. and Mariella Mehr were Stettbacher’s patients during the same period, but their experiences seem to be opposites.

While U. writes about being abused and threatened, Mariella Mehr writes about the therapy and the therapist as being very safe and supporting. While U. writes about being totally isolated during the first weeks of the therapy, Mariella writes about a friend visiting her there. While U. writes about getting injections to calm down, Mariella seems to deal with the horrible events of her past by just doing the therapy. While U. writes about being forced into memories in a rough way without her fear being taken into account, and as a result of that, about having to deal with too much at once, it is clear in Mariella’s book, that she has been treated with great care and respect and that she deals with the past that comes to her consciousness bit by bit. While U. describes the therapy room more or less as a room of torture, Mariella writes about it in a very tender way, and calls it a “warm belly”. While U. tells that she became very ill because of all this, Mariella tells that this therapy saved her life.

Why these totally different stories? Did they get such different therapies from the same therapist? I don’t know. I can’t make these stories fit together. I can’t manage to make sense out of these two stories. I feel really puzzled and confused since they both seem to be telling the truth. Am I right or wrong in believing them both? I don’t know.

When I read the Appendix, I am a bit irritated by the statement of the Psychiatric Polyclinic that U. went to, that they already had had to take over more of Stettbacher’s patients in similar regressive states like U. Of course, I am not acquainted with this hospital, but I presume that it is not very different from Dutch hospitals, and with them I am very much acquainted. I presume that the results of this hospital will not be better than the results of psychiatric hospitals in The Netherlands, and this means that they are regularly having their own patients back in hospital in all sorts of regressive states. I think it is a cheap shot to suggest that this especially happens to Stettbacher’s patients. Even when this hospital’s treatment is comparable with the best treatment that I experienced myself in a psychiatric hospital, it is nothing to be proud of.

When I look at myself, I see that I have been in psychiatric hospitals six times before I started working with Stettbacher’s self-help therapy. After that, I have been in a psychiatric hospital only once, about five months after I started working now and then with the four steps. This time I was on a ward where I had been before, and the staff was very positive about the progress that I had made since the last time I was there. They advised me to continue the therapy I was doing. It was the last time I have been in a psychiatric hospital.

Also, I do not find it a failure when someone doing self-help therapy needs support or help for some time. What I find irritating in the Appendix is the suggestive tone of this part of the interview, because of my own bad experiences with psychiatric hospitals and the bad experiences of other patients that I saw there. And especially because of my best friend who did not survive this wrong treatment and died in 1993. A “natural” death from exhaustion, despair and hopelessness. Her heart just stopped one night. I loved her and I still miss her. I frequently wonder whether she would have stayed alive with Stettbacher’s and Jenson’s therapy.

It would be interesting to do research on how often people end up in a psychiatric hospital, to compare people who are and who are not working with Stettbacher’s self-help therapy. In my case, the result is positive for Stettbacher.

To be correct, these self-help Stettbacher patients are in another situation than U. was, because they weren’t abused during the therapy, like she was.

What does Stettbacher’s behavior say about the four steps or about the therapy of Jenson? As I see it, neither Stettbacher nor Jenson “invented” this therapy. It is just a natural process that nature gave to human beings. Jenson and Stettbacher noticed and described this process, both of them in their own way. And I think they did a wonderful job, and they must have had a lot of courage and integrity to succeed. I am very grateful for it.

Alice Miller wrote about the four steps being a natural process herself in her book Abandoned Knowledge. Why did she change her mind? I do not understand why Alice Miller throws away a natural process because someone who described it made serious mistakes as a therapist. Nature does not change because of one man’s mistakes, even if these are very serious mistakes. Also, there is the question whether Miller rejects only Stettbacher, or rejects Jenson as well, or perhaps rejects self-help and Stettbacher in particular. In her Communication Alice Miller doesn’t mention Jenson at all. If she rejected Stettbacher’s four steps but still supported Jenson’s therapy, I would like to know how she can match this with the fact that the two therapies are almost the same. As I see it, Jenson’s therapy is certainly not “another therapy”, it is just a part of Stettbacher’s therapy.

I wonder if Alice Miller now regrets having worked with the four steps herself? Does she regret the healing it gave her? Would she like to be again in the condition she was in before she did this therapy? Does she have “negative side-effects” herself? Is she still dealing with her past? If so, how does she do that if she does not perceive, feel, think and articulate needs anymore? How does one do therapy when one leaves out these four elements? These are all questions I have. I would like to have answers to these questions. But neither in her Communication nor in the Appendix she writes about these things. I do not understand Alice Miller anymore.

The more I think about it and go through all her remarks, the more negative I become about Alice Miller and the more angry I become with her. I find her present view and the vague but emotional, piercing and even manipulating way she brings it, irresponsible. She shouldn’t do this to her readers.

I also feel that her rejection of the four steps could have had most serious consequences for me if I had known about it earlier. Now that I read it, at the end of 1996 and the beginning of 1997, I am strong enough to do the therapy without her support. I feel able to judge a therapy myself, and I feel able to deal with it when I am confused and feel “abandoned” by her. But that was different some years before. I couldn’t do without her support then and I don’t know if I would have survived. I wonder if Alice Miller realizes such consequences of what she is doing.

I am not suggesting that she would be responsible if someone would kill himself after having read her Communication. The fact that I give her the honor of having saved my life in the past because she did write the right things then, does not mean that I would blame her for someone’s death when she writes things that I think are wrong. I think everyone is himself responsible for a decision about suicide. But I do think that Alice Miller should reconsider carefully what she is doing. I do think that she, because of her influence as a writer, is responsible for writing the truth, and I have doubts whether she is writing the full truth in her Communication and other publications by her in this period. I want her to be open and honest about her true, and maybe personal, reasons for rejecting the four steps and Stettbacher as a person and therapist. What she writes now is at least not clear. I feel disappointed with her, too. I thought she could do better than this.

I still appreciate Alice Miller enormously, for her earlier books and for the courage she showed by writing those books. Her books have been extremely important to me, they saved my life, and I am really grateful to her. Without her books I would have died long before Stettbacher’s book was even published. She gave me hope and (some) understanding of myself, and that made it possible for me to stay alive until I found a good therapy. I owe her a lot. But what I am most grateful of, is that she brought me to Stettbacher’s self-help therapy. In the end it was this method that saved my life. So I am in a strange situation with my gratitude to her at the moment.

I remember that some years before, I did think about writing to Alice Miller. At that moment no therapy seemed to help and I thought that I also had tried Stettbacher’s therapy or even still did it (although I at the most once in several months did something with the four steps, superficially) and that this therapy didn’t work with me. I didn’t know what to do anymore and wondered why the therapy of the four steps worked well with Alice Miller but not with me. Now, I thank heaven that I didn’t write to Alice Miller then, but instead, some time later, to Stettbacher. Alice Miller would have added me to her list of people for whom self-help was a failure and wouldn’t have done anything to help me. Stettbacher sent me information that made it possible for me to continue therapy. Now that I read what Alice Miller was doing in the years before 1997, this feels like a narrow escape.

I feel it is not really fair towards Alice Miller that I criticize her so much, in public, on the Internet, anonymously and without writing to herself. Therefore I send her in February 1997 the three letters from me that by then have been published on the Primal Psychotherapy Page, together with a letter in which I tell her more about myself. She doesn’t reply, and later I regret that I entrusted her with my personal history.

In the months that follow I write more letters to the Primal Psychotherapy Page, because of more information that I get.

I read that Alice Miller stated in an interview that it doesn’t matter which therapy method is used by a therapist, since it is the human contact with the therapist that cures, and that’s what should be central in the therapy. I find this a very dangerous idea. I experienced with Robert that this doesn’t work, that the method is crucial and that a therapy that is based on the healing relationship with the therapist, makes the patient totally dependent on the therapist, more than any other therapy “method”. Such a therapy makes it almost impossible for the patient to see what is happening in the therapy and to have control over the situation. Also, using this “method” it is really tempting for the therapist to use the therapy for his own narcissistic needs, since the progress of the patient depends on him as a person. This also creates the risk that the therapist is central in the therapy instead of the patient.

These are my own experiences with this way of doing therapy, and although I know that people are different, I find it a really bad idea to recommend this way of working. For me, the warmth of the human contact has been really addictive and that made it so hard to leave the therapy, despite the fact that there wasn’t any improvement of my symptoms and continuing of the therapy wasn’t reasonable on account of the results. Finally, after nine years I left Robert, feeling used by him.

I don’t understand how Alice Miller can recommend a way of doing therapy that makes patients so extremely dependent on the therapist. This is in contradiction with her former ideas, as she described them in her books. Then she explicitly sought to avoid the pitfall of dependency and of being used by a therapist. I myself came to the conclusion that therapy always should include self-help, even when it is accompanied by a therapist. A patient should always have the information with which he or she can help himself or herself in the therapy.

Still, a lot of questions about Stettbacher and Alice Miller remain unanswered. But I feel I can continue therapy in spite of all these unsolved mysteries. For me, the four steps are a good therapy method. I needed more information than Stettbacher’s and Alice Miller’s books gave me, but from the moment I got this information, I was able to do the therapy and get good results with it. I do not find it easy to do this therapy, I have a hard time with the memories I encounter, but for that I blame my parents and not the therapy.

I have done so many therapies, and nothing worked, everything ended up as a disaster and made me more ill. The therapies of Stettbacher and Jenson are the first and until now only therapies that really have lasting positive results, and doing these therapies, I started understanding why. I feel it would be insane to give up this therapy and go back to any of these other methods — speech therapy, RET, medication, psychoanalysis, psychodrama, psychosynthesis, Gestalt, haptonomy, rebirthing, regression therapy, primal therapy, Reichian therapy, rage work, dynamic meditation, encounter, Voice Dialogue, NLP, guided imagination, hypnosis, creative therapy, spiritual “paths” or whatever else I did, growth processes, individual processes, psychiatric hospitalizations, whatever. It only brought me misery, and I will certainly not return to this. Doing no therapy at all but liberate myself by artistic expression, as Alice Miller now recommends in her newest edition of The Drama of the Gifted Child I find too naive to take seriously. I already experienced that this does not work. Doing nothing and letting myself drown, I also do not find a good idea.

So I continue to fight for my life, I continue processing my past using the four steps, every time the past gets in my way. Anyhow, I do run into old pain in my daily life, this pain is there, this is reality, and the best thing I can do is, as I see it, to process the pain every time it hurts me. That’s what I did in my self-help therapy until now, and I can’t find anything wrong in it. On the contrary, to me it seems good and constructive.

Someone tells me that Alice Miller is angry with Stettbacher because her son, a psychiatrist, recommended himself offering the therapy of the four steps, and Stettbacher protested since Miller’s son hasn’t been trained by Stettbacher. I don’t know whether there is truth in this or whether it is just gossip, but even if it is true, I feel Miller’s behavior is peculiar.

In the meantime, Alice Miller writes that it is impossible to discover one’s history by doing therapy, and even tells one shouldn’t try. This contradicts all her former writings. I wonder whether she encountered a part of her history that she doesn’t want to acknowledge. But since she doesn’t tell anything about this, I can only guess. I don’t know why she writes all this, but I do know that it doesn’t fit with my experiences with Stettbacher’s therapy.

Finally, my conclusion is that Alice Miller is not a reliable guide to therapy anymore, like she was for such a long time. Her present negative ideas about self-help with the four steps seem to me a personal problem of herself, and I won’t let my life be influenced by that anymore. I have thought over all the arguments that Alice Miller wrote, and have come to my own conclusions. I don’t try to find out anymore what could be the matter with Alice Miller. I am busy with my own life, not with hers. I don’t need Miller’s consent and approval. I continue helping myself. And with success.