Monday, October 27, 1997
2 pm. Initial Session with Jesse Trent. Jesse came in for an initial appointment after a brief telephone call. His wife, Maddie Trent, works for SII as a graphic artist and Jesse came to see me under her health insurance. Jesse is quite tall and thin--he stoops somewhat elaborately to try to appear shorter. He has dark hair and blue eyes. Although he is 28, he appears much younger--although I'm terrible at that game, I would have guessed he was about 20. Jesse told me his story in a quite matter of fact way. He seems like a logical, organized thinker. Jesse and Maddie are from St. Louis, Missouri. He met his wife when he was 22 and she was 20, and they had a whirlwind romance which resulted in Maddie become pregnant. Jesse wanted to marry her regardless of her pregnancy, and Maddie and Jesse were happily contemplating their future together with a child despite the pronounced displeasure of their respective parents. But after the marriage, when Maddie was seven months pregnant, her car was hit by another driven by a young kid who ran a stop sign. Maddie was severely injured and lost the baby. But with time, and each other's support, they got through the crisis and Jesse feels their marriage got even stronger as a result. Jesse worked as a photographer, mostly doing weddings, and Maddie went to college and became a graphic artist. They moved to San Francisco a year ago after Maddie accepted a position with SII. After they were here, Jesse found a position in a used bookstore, which he likes very much. But six weeks ago, Jesse went back to St. Louis for his parents' 30th anniversary. Maddie, at the last minute, decided to stay behind and finish some work on deadline. While Jesse was away, someone broke into their apartment and brutally raped and beat Maddie. She lost consciousness while being suffocated with a pillow towards the end of the lengthy ordeal, and the rapist, probably thinking she was dead, finally left. Maddie called the police, who notified Jesse in St. Louis. He was able to return quickly and arrived to find Maddie sedated in the hospital. While the police have "a few" suspects, they have yet to make an arrest. Maddie is angry and bitter, but she's recovered physically. She's in therapy, but Jesse feels that she has become very distant from him. My first advice to Jesse was for him to make it clear to Maddie that the rape hasn't changed the way that he feels about her, and that he doesn't feel that it was somehow her fault. Jesse said that Maddie was quite clear on the fact that it wasn't her fault, but he indicated that she might blame him in some way. Perhaps she feels that he should have been there to protect her. We ran out of time, but I asked Jesse to keep a journal and try to use it to articulate his thoughts and feelings about the rape. Everyone is going to be very focused on Maddie's feelings, as is appropriate, but Jesse is also clearly a victim of this brutal attack.

Monday, November 3, 1997
2 pm. Second Session with Jesse Trent. Although Jesse is trying hard to be loving and supportive to his wife after the rape, he is beginning to express a little of his own anger. Jesse is angry at the rapist, of course, but he has directed that anger appropriately at the perpetrator who is still at large. But the anger that is most destructive of his relationship with Maddie is that caused by her refusal to allow Jesse to get close to her and to try to help her deal with the emotional ramifications of the assault. She has distanced herself from him, using as an excuse her accusation that he shouldn't have gone back to St. Louis leaving her alone in the apartment at the time she was assaulted. It is very difficult to be emotionally supportive and defensive at the same time. Mostly, people are unable to nurture when there are unresolved issues of blame. Jesse recalls the emotionally healthy way that they supported each other after the car accident which resulted in Maddie's miscarriage, and he wants to be there for Maddie now in the same way. But she rebuffs his overtures with some pretty strong invective clearly designed to wound Jesse--attacks that he hasn't done anything with his life and even that he looked effeminate and foolish riding the scooter which she had given to him as a gift. While there are some supports for the victims of an assault such as Maddie suffered, there is little for the many other victims left by this type of attack. While Maddie undergoes therapy and rape crisis counseling, and while she fills her nights with self defense classes geared to women, Jesse is afraid to reveal to Maddie that he is in therapy, because he doesn't want her to perceive him as selfish. Meanwhile, both Jesse's and Maddie's families are really impossible. Jesse's family apparently went so far as to suggest that Maddie's attire--which Jesse describes as baggy t-shirts and jeans--somehow prompted the assault in her own apartment! And Maddie's family places the blame squarely at Jesse's feet both for not being there that night and for prompting the move to San Francisco, which they view as crime-infested and morally reprehensible. As emotionally distant as Maddie feels to Jesse right now, there are signs that Maddie realizes that Jesse is truly not to blame--she refused to consider her parent's suggestion that she leave Jesse and move back with them. I believe that Maddie just needs a focus of blame so that the assault doesn't seem wholly uncontrollable. If Jesse is to blame, then some control can be reasserted. Moreover, Maddie needs to turn inward to shield her vulnerability. Although I'm not a big fan of repression, I think that sometimes it is not productive to display large emotional wounds too early outside of a controlled clinical setting. Perhaps Maddie senses that she needs to internalize her feelings first before she can open up with Jesse. I hope that Maddie's therapist is interested in consolidating the support structures which Maddie has available to her, rather than utilizing this opportunity to advance a feminist political agenda--exploring all of Maddie's feelings about relationships with men in general, and Jesse in particular.

Monday, November 10, 1997
2 pm. Third Session with Jesse Trent. Jesse is making me see the therapeutic counseling process from an outsider's perspective--a powerless feeling, actually. Jesse is watching his wife turn away from him and believes that much of her attitude can be traced to the other members of her rape support group. They've apparently formed a group independent of the Rape Crisis Center which meets without a mediator. Together, these women share their anger and pain. There's a power there, and it multiplies with their solidarity. In my experience, however, if that power is unmediated by someone who has the ability to retain perspective, it usually acts a destructive force. I've counseled rape victims before, both here in San Francisco and back at Columbia. I've even done some couple work after a rape. But I've never been wholly on the outside of the situation, dealing with just the partner of a rape victim. And without access to Maddie herself, I don't really know how to counsel Jesse. I can make him feel better about himself, perhaps, but I can do little to relieve his actual complaint, which is reasonable--how does he get his wife back? I'm hopeful that if the rapist is captured, Maddie will be able to redirect her anger towards a more appropriate target. Apparently, another woman in the building was recently raped as well, perhaps by the same attacker. Jesse told me that the police believe it may be someone who has key access to the secured building in which they live. Maddie's reaction to the new assault was predictably intense. Jesse told me that, prior to the rape, he and Maddie had some mild fertility problems--difficulties conceiving--but they had only tried for about five months. However, Jesse noted some strains had appeared in their relationship--most notably, Jesse felt that Maddie had little sympathy or understanding over the sexual performance difficulties that he began to experience when asked to perform on cue during Maddie's ovulation.

Monday, November 17, 1997
2 pm. Fourth Session with Jesse Trent. Maddie is eleven weeks pregnant and the paternity of the child is in doubt--it could be the rapist's. Jesse learned about the pregnancy by listening in on Maddie's telephone call to Sammy. His emotionally vulnerable reaction triggered a reconciliation of sorts--at least an understanding by Maddie that Jesse has also been hurt by recent events and a willingness on her part to accept some efforts at comforting from Jesse. I warned Jesse not to be devastated if Maddie's current openness to him changes. Such reconciliations frequently vascilate in fits and starts. Maddie might soon swing back to being emotionally distant, but the current thaw in their relations is a positive beginning. Maddie's parents are going to descend upon the emotionally beleaguered couple for Thanksgiving. Jesse describes them as not as bad as his parents, but since they are "bible thumpers," he doesn't expect much understanding from them about the choices that they are facing. Jesse was exceedingly grateful for some information I gave him about in utero genetic testing. He was unaware that they could determine the paternity of the fetus while there was still time to elect to terminate the pregnancy. I furnished him with a web address that has some helpful information.

Monday, November 24, 1997
2 pm. Fifth Session with Jesse Trent. Things are going extremely well for Jesse in his relationship with Maddie. She has opened up a lot more to him and seems willing to seek some comfort with him. While she is not ready to renew a sexual relationship yet, she is willing to lie with him and kiss and touch. I told Jesse that she will initiate sexual activity when she is ready and that it is best to allow her to have all the control at this stage in her healing. Their OB was sympathetic to their concerns and said that he would perform amniocentesis at 16 or 17 weeks to gather the cellular material necessary for the genetic testing to determine paternity. Seeing the fetus during ultrasound was an emotional moment for both Jesse and Maddie--I suspect that if it becomes necessary to terminate the pregnancy, Maddie will suffer a serious relapse in her ability to see Jesse as an important support. Jesse's in-laws are arriving tomorrow to spend Thanksgiving with Maddie. I'm sure that's going to be a strain on everyone involved. Jesse wanted me to read a letter he wrote to Maddie which expresses much of what he has told me--that he is willing to wait until Maddie is ready to renew a sexual relationship, that he is emotionally there for her, and that he loves her.

Monday, July 27, 1998
1 pm. Telephone Conversation with Jesse Trent. I received a call from Jessie Trent, who I haven't seen since November of 1997. Jessie told me that Maddie delivered a baby girl and that Jessie is the genetic father. He sounded terribly relieved about that, as if he had dodged a bullet, and I can't say that I blame him. However, he and his wife do appear to be going through some stress, and Jessie wants me to take on both of them as patients. I tried to demur but he insisted. I explained that there was a conflict, that I would have to treat each of them as separate, keep what each of them said separate from the other, and that the advice I'd give would be in light of what was appropriate for each of them as individuals but not necessarily as a couple. Jessie was ready to agree to all of that. Of course, I'll have to reiterate all of that to Maddie and make sure that she understands and agrees to the ground rules. We set up an appointment for Jesse next Monday at 10 am.

Monday, August 3, 1998
11 am. Sixth Session with Jesse Trent. We spent this session getting caught up to date on the tumultuous events in Jesse's life. Just after Thanksgiving, during a visit, Maddie's parents found out about the pregnancy and Maddie's rape. They are religious people who don't believe in abortion under any circumstances. They wanted Maddie to return with them to St. Louis, and Maddie might have gone if not for the timely and effective intervention of their friend Sammy. Sammy also sat down Maddie and Jesse as a couple and made them talk to each other. In January, they got the results of the genetic testing and found that Jesse is the father. That enabled Jesse to focus on Maddie's pregnancy and the coming baby. In March, the police caught the man they believed raped Maddie after another woman in the area was raped and killed. The man apparently has attacked a number of women in the area. Jesse told me that he had been reading about rape, and that rapist fall into categories based upon their motives for committing rape. This serial rapist falls into the "sadistic" category. The man in custody was employed as the property manager of the building they were living in when Maddie was attacked. He had showed them the apartment when they were first deciding whether to live there. Jesse said that he didn't match his image of a deranged maniac--he was very clean-cut. The police want Maddie to help make a case against this man, and the pressure she felt as a result was beginning to effect her pregnancy. Maddie's doctor put her on bed rest after she began to suffer from preterm labor. The baby, Natalie Ann Trent, was born after her due date, on May 14th, 1998. She's now 3 months old and healthy. Maddie went back to work in July and Jesse is the primary caregiver during the day. The trial for the rapist is scheduled for the end of September. All in all, the relationship between Maddie and Jesse seems quite improved and currently stable, although there are the normal stresses, including a substantial adjustment, that come with becoming new parents. Although Jesse didn't mention it, I'd suspect that they are not getting much sleep, either. But Jesse and Maddie both want to see the same therapist--not as a couple, but as two individuals. I explained the conflicts, but Jesse was adamant that this is what he wants. Jesse is hoping they'll each gain some perspective on their life. We ended the session a bit early so that Jesse could get Maddie back from the neighbor who was watching her.


Button to Jesse Trent's Patient File Jesse Trent's Patient File
Button to Madeline Trent's Patient File Madeline Trent's Patient File
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