PAS -"Professionals Need to 'Name the Pain'"

A growing number of clinicians are beginning to recognise that there is an identifiable syndrome which must be addressed, and not used for partisan purposes in the abortion debate.
  • A sense of relief immediately after an abortion is common.
  • Many women deny their hurt, suffering in silence, their pain a secret burden.
  • Our society does not acknowledge the validity of grieving an abortion.
  • Symptoms of repressed grief are most likely to surface from six months to two years after the trauma occurs
  • Many women suffer from major psychological trauma, profoundly affecting their lives
  • The need for increased awareness of PAS is paramount among those in the helping professions.
In 1981 Dr. Vincent Rue provided the first clinical evidence of post-abortion trauma, identifying this psychological condition as "Post-abortion Syndrome" in testimony before the U.S. Congress.

Rue is a Co-Director of the Institute for Pregnancy Loss, Fellow of the American Academy of Experts in Traumatic Stress and a Member of the International Society for Traumatic Stress Studies.

Dr Rue says that while it is true that most women feel a sense of relief immediately following an abortion (the source of the immediate crisis has been removed), a "growing body of evidence supports the contention that abortion has a painful aftermath, regardless of the woman's religious beliefs, or how positive she may have felt beforehand about her decision to abort."

Mental health professionals who accept abortion as a woman's right continue to maintain, in psychological and medical literature, that abortion has "limited or no psychological after-effects." The 'few' who suffer guilt and depression, do so, apparently, as a result of cultural or religious indoctrination.

In a paper, "Professionals Need to 'Name the Pain", Rue says that there are two obstacles that prevent professional recognition of post-abortion trauma as a syndrome. (A syndrome is a group of symptoms that collectively indicate or characterise a disease, a psychological disorder, or another abnormal condition.) The two obstacles Rue names are:
  • helping professions who all too often ignore or minimise post abortion problems (some even consider it a 'positive experience'), and
  • many of the women themselves deny their hurt, suffering in silence and keeping their pain a secret. Read The Big Secret.
Rue states that because society does not acknowledge the validity of grieving an abortion, when women "express any negative feelings, they are told by friends, family and therapists alike that they have no legitimate reason to feel that way. After all, they chose to abort, didn't they?"

It has long been recognised that repressing grief and pain have eventual and inevitable consequences of emotional, psychological and physical malfunctions, and Rue identifies these as Post-Abortion Syndrome,(PAS).

Delayed Effects
Much of the research and studies on the psychological after-effects of abortion point out that early studies mostly concentrated on the reactions of women shortly after their abortion.

Those researchers who, like Rue, believe that there is evidence that significant numbers of women experience a serious psychological aftermath to their abortions, point out that symptoms of repressed grief are most likely to surface from six months to two years (or longer) after the trauma occurs.

Rue says that research that has studied women months and years after their abortions have revealed a much higher percentage of women negatively affected, sometimes the majority of women in the studies.

According to Rue, this comes as no surprise to clinicians. He says that while abortion may not have been the initial reason women sought help from a counsellor ( it may have been marital conflict, depression, chemical dependency, etc...), the common factor has been the abortion. He says;
"The women suffered from an unresolved trauma, profoundly impacting their current lives. It had in fact been a major death experience, typically denied.

As reports surfaced in counselling circles and a few were printed in psychotherapy journals, it appeared that in the wake of mass legalised abortion we were seeing a swelling wave of post-abortion problems. Moreover, the post-abortion reactions of these women were remarkably similar. It was evident that we were dealing with an identifiable syndrome."
(Some of the common symptoms of PAS are listed here.)

Many women who are otherwise able to manage repressed grief quite successfully, may experience intense reactions, or thoughts of suicide, on the anniversary of the abortion or the expected birthdate of the child.

Rue points out that the need for increased awareness of PAS is paramount among those in the helping professions, saying:
"The longer we professionally deny the psychological damage done in abortion, the greater harm we do to those who seek help. By naming the pain, and diagnosing the syndrome, we validate the anguish of those who now suffer alone, and enable them to work through their grief and guilt to find healing and reconciliation."
When Counselling Side-steps the Problem
Jim Benefield, a licensed Marriage, Family and Child Counselor (MFCC) in San Diego, was approached by a woman who told him, "I came to you because my best friend said you really helped her, but I'm not sure I want a male therapist," she said. "I'm more comfortable with a woman, but my last therapist was a woman who changed my life, and not for the better."

Having had an abortion ten years previously that had affected her quite badly, when Jenny found herself pregnant again, her partner, Robert, insisted she have an abortion. When Jenny refused he told her she needed to 'see a shrink.'

Seeking counselling, Jenny told the woman therapist that her past ten years have been haunted by the memory of my abortion, and that there was no way she could live through another one.

By the fourth session Jenny realised the therapist was looking at it from Robert's perspective, not hers.
"It dawned on me that she was protecting Robert, not me. It was the things she said: 'He's really scared.' 'He's really not ready to settle down.' 'This doesn't appear to be the right time for a baby in your relationship with Robert. It's decision-making time for you. What is more important to you at this time, your relationship with Robert or losing that by having this baby?' What will happen to you and your career, a career you've worked hard for these past years, if you have this baby? What will this do to your relationship with your parents? Have you thought about the possibility that maybe you're stronger than you think you are, and that deep down you realize life would be simpler without a child in your life right now?"

"She asked a lot of questions like these, and each one began to feel like a pin in my stomach. At the end of the fourth session she said, 'You said you hated having to go to the abortion clinic by yourself last time. If you want someone to go with you to the clinic, I'll take you. Would you like me to take you?'"
Jenny felt sick and confused and two weeks later she fired the therapist and had the abortion.

Later, seeking help from Benefield, Jenny, while admitting that she, and not her therapist or Robert or anyone else, is the 'owner' of her decisions, expressed a lot of anger at her previous therapist for 'protecting' Robert and adding to her confusion.

Benefield says out that Jenny had gone to the woman therapist with a sharply ego-dystonic problem. He describes 'dystonic' as anything that is unacceptable to the ego. 'Syntonic' refers to the acceptability of ideas or impulses to the ego, which receives them as compatible with its principles. If a woman went to a counsellor and said, "I had an abortion ten years ago but it's not a problem for me." The counsellor is then under no obligation to pursue the subject, since it presents no conflict.

But, Benefield points out, Jenny's position was emphatic: "My first abortion ruined my life, there's no way I can do it again. It would kill me." Benefield says:

"When confronted with a situation so obviously ego-dystonic, the therapist is obliged to address it as one of the main goals of therapy. For the therapist to side-step this problem shows poor judgment and unethical treatment. But to offer to facilitate an action that would exacerbate the psychological problem -- as this therapist did -- is not only grossly unethical, it may be grounds for a civil lawsuit by the client."

Fathers, too

Rue, who also deals extensively with post-abortion issues among men, points out that women are not the only ones who suffer following an abortion. Those he has also come across in his practice who experience negative psychological consequences are:
  • fathers
  • surviving siblings
  • grandparents
  • abortion providers
He believes that fathers of the aborted child in particular have been "legally and psychologically ignored both in the abortion decisions and in its aftermath. These 'forgotten fathers' often suffer the trauma of abortion as intensively as their female partners."