“There is something else going on, isn’t there?” She was not taking her medication again. She always stopped when something else was going on at home. A breakup. Money trouble. Unemployment. It was a good bet.

“Doc, I can’t do it.” There was a quiet sob.

I looked up from the computer. She had tears streaming down her face again. “Do what?” I had seen the tears before. I felt annoyance rising up inside me. I put the computer down on the counter and handed her a box of tissues. 

Then, the whole bloody mess came spilling out.

Her father had molested her repeatedly for years. In fact, she had been impregnated by him when she was twelve and the baby was put up for adoption. Now, as a young adult with two small children, her father was trying to reinsert himself into her life. Seeking counsel from her pastor she was told she had to forgive him, to allow him back, allow him access to herself and her children. 

If she did not, she would be damned forever.

“I just cannot do it.” She moaned through clinched teeth, “If he touches my kids I will kill him.”

I will help you.

“That is not what forgiveness is.”

“What do you mean?” Her eyes bored into me. 

“That is not Biblical forgiveness, being told you have to allow him back into your life in order to curry favor with God.”


“How do I know? How can I question what a pastor says?”


“I have a personal interest in forgiveness, particularly Biblical forgiveness. Forgiveness is for you, not him or anyone else. It is something that happens inside of you and cannot be mandated by anyone. It does not demand that you maintain any sort of contact with that man and it certainly does not demand that you endanger your kids.”

Her whole life, all of my experiences with her over the years, fell into place. The burden this woman was carrying around, weighing her down… Now some prick involved in spiritual malpractice?

“You ever get counseling?”

“I had to see one that wasn’t worth crap back when it all happened.”

“You need to find a new church.” She nodded as she wiped snot from her nose. “And you need a real counselor.” 

Except that she was at the free county clinic seeing me. She floated from one part time job to the next, no high school diploma. There was no counseling available to her. I still worry about her and where she is now…


131 thoughts on “Malpractice

  1. Argh! I want to find that pastor and share a piece of my mind with him!

    I can’t do that. What I can say is “thank you” for lending her a different, more healing perspective. I hope she is able to find resources to confirm that and find the kind of healing that comes with the forgiveness you describe.

    My life is better for forgiving my dad, as it is better for my dad not being in my life.

    Liked by 8 people

      • Having been through a similar experience (though not impregnated), it upsets me that a pastor would say that. I am a Christian and I have forgiven my biological donor (doesn’t deserve to be called a dad). I don’t have any contact with him and would not trust him around my kid. I hope that pastor is not a pastor for long. Who knows how many other people he’s giving horrible advice to and who might take his advice.

        Liked by 1 person

  2. Oh my goodness I can’t tell you how much it enrages me when religion gets in the way of truth and safety. It’s my story in many ways. I’ll bet you made a huge difference in her that day. Maybe even life saving.
    I’m smiling from ear to ear with what you showed her that day!

    Liked by 1 person

  3. Hey Victo,

    I found your post incredibly moving, and your wise counsel compassionately reaffirming. My thoughts are with the woman in your story, who I hope sincerely has found peace and happiness both for herself and her family, clarity in her personal judgement and the confidence in herself to forgive but remain independent of her father. I have other far less congenial thoughts about the suitability of the misdirected pastor to hold such a responsible post in the community, and uncompromising thoughts about the evil brutality of the depraved father…

    I must say Victo, the further I read into your insightful Blog, the more I become appreciative of the real depth of your professional (and humane) qualities and attributes, and the more I come to understand the basic need for a uniquely tailored and ‘holistic’ approach to responsible medical practice that builds on the skills of the few rather than reliance upon the individual to fulfil a patient’s every need. The intimate weight of that burden should not be placed entirely upon the shoulders of one person but shared amongst key players able to treat the body as an interconnected whole. And yet, I have no factual idea if presenting symptoms are directly influenced physically by psychological disturbance, but my heart always leads me to believe otherwise.


    DN – 26/05/2015

    Liked by 3 people

  4. Just wants to make you stand up and shout, “Thank God I am not living in a Burqa Country!” OMG: Imagine what response you would get were this to come out to the authorities! Imagine what response I would get that this would come out to the authorities! Imagine what response would happen to your readers were this to come out to the authorities. Could it be any clearer? I hope more readers find you and BroadBlogs for your insights and clarity. PLEASE look at my piece on Bulls**t and the one on Truth. Thanks.


  5. I have hope for her. Minding her children will help her through. I didn’t go down the road of counselling, but time, distance, and him moving to the US definitely helped me heal.
    As for forgiveness…. not a chance in the world will I forgive my abuser. He abused so many, but I will not spend my life hating or being angry. He took my childhood, the rest of my life is mine.
    It sickens me to think she could not access counselling.

    Liked by 2 people

    • “…I will not spend my life hating or being angry.” Some would say that IS forgiveness. I think that forgiveness can and perhaps should coexist with hate in some cases. It is the decision to not allow it to destroy yourself that is the key.

      Liked by 2 people

  6. I’d be curious to see the prerequisites for becoming a pastor in most “churches”. If these religious are doling out that kind of dangerous advice, there is a clear need for more and better education. This makes me sad/angry all at once. So glad she opened up to you, Doc. Van

    Liked by 2 people

  7. I already have 4259 posts to write based on posts you’ve written, which send my wild thoughts off onto tangents. :::me shaking my fist in the air at you:::

    Anger: At the religion that would condone such horrific counsel. (One of the many reasons I hate religion, across the board.) At the original perpetrator. At the “system” which allows poor people to fall through the cracks (in the hopes they hurry up and dieβ€”now that it is a war on the poor and not a war on poverty).

    Empathy. Been there, or close enough to it.

    Wondering if it is easier for doctors to wander into this realm than it was for me as an LMT. As an LMT I tried so hard to not wander into ‘playing doctor’ by talking about medical things beyond my scope. I was paranoid, mainly because so many of my peers did NOT worry about it and so blithely spouted all sorts of things they should not have. That line not to cross was pretty easy, in my mind. The other line I wrestled with… what you are talking about. I heard all sorts of things. I wanted to offer advice and yet I really didn’t. If there was a referral to someone appropriate, great, but there usually wasn’t. And I’d want to scream, “Are you nuts? Keep that bastard away from you and your family!” (In the situation you described…) but it always worried me, because what if I was wrong? What if the patient/client came back to me with a yelling vendetta (or worse).

    As an LMT I was amazed at what kind of things people wanted my advice about! They would have taken it too (many of them). I can only imagine it is exponentially more so with an MD behind your name. I don’t envy you the tap dance.

    Liked by 3 people

    • One of the things that makes manipulative therapy and massage therapy so helpful is not so much the touch itself, which is therapeutic, but the time taken to talk and get things off of their chest. No distractions. I am a DO. I have practiced manipulative medicine some (a whole other series of posts) and truthfully, I did not know what the hell I was doing. But I helped people. Probably that was more from listening than anything my hands were doing. Most people don’t need advice. They can figure it out for themselves, given the opportunity. That being said, I love to tell people what to do. You already know that, though! πŸ˜‰

      Liked by 1 person

    • The same things happen to schoolteachers. In only five years in the classroom, I had students who were physically, sexually, and emotionally abused, who had previously-undiagnosed Tourette’s, severe ADHD, or were self-harming, a child whose sister was kidnapped and impregnated… I had parents ask me all SORTS of questions. There was what the District permitted me to answer, and there was what I knew was best for the child and the family. I never gave advice–who was I to give medical advice, or parenting advice about someone else’s child? I simply asked Socratic questions and made analogies with my own knowledge and experiences, and let the parent draw her or his own conclusions.

      Liked by 1 person

  8. Good for you (and good for her and especially good for her kids).

    I’m sure the pastor was preaching good family values … I know that there is a special level in hell for folks like him (and the father); I just wish they would all end up there sooner rather than later to mitigate the damage.

    And that pastor should be reported to the police.

    Liked by 2 people

  9. I hope you share what you have discovered about childhood trauma and the ACE study and the connection with later life health issues…..
    My first foray into therapy was with a Mega-Christian church that had a counseling program attached to it. It was supposedly staff with professionally licensed counselors. I was just starting to have flash backs and they were very disconnected. She suggested I write my thoughts down about my childhood. I wrote 32 pages….. I handed it to her on my next visit. She began to read it, sighing continually, until she finally burst into tears, praised Jesus, and left the room…….. it was the last time I really had much to do with any Christian counseling or for that fact….. Christian! Just not my cup of tea.

    Liked by 3 people

  10. Wow – intense post Victo. I am wary of religion and don’t partake. Faith in a man made institution run primarily by men seems dangerous to me. i understand that it is to be used as a stairway, a means of approach to God but it is not held accountable. And neither are any of its representatives. How can any person or institution learn, grow, identify mistakes when there is no accountability? As an aside I have a great deal of faith in God and cannot see how the universe could exist without a Supreme Being synonymous with love. . .Priests, minsters etc I can do without. The advice given to your patient by her religious adviser should be considered criminal or at least legally actionable – as you pointed out in your title. It threatens the well being of adults and minors. But no one is held accountable for that.

    I read with interest the material on ACE – eye opening. I’ve never seen such research and it seems very convincing. The best is the strength of the conclusions – there were no assumptions or theories involved – it was pure data with an inescapable conclusion. No need to understand the mechanism or causality- the relationship is undeniable. I have dealt with a lot of statistics in my years and i don’t think i have ever seen as solid a link.

    Your compassion is amazing Victo – .it is so wonderful to meet someone like yourself who allows themself to be compassionate. Thank you and I hope your patient stays safe and healthy.. .

    Liked by 3 people

    • I am at the same place right now that you are at, in that I believe in a supreme being that is synonymous with love, but I have very little use for organized religion. The ACE thing makes a lot of sense, I agree, but it does not hold true for everyone. Studying those outliers would be fascinating, I think…

      Liked by 1 person

      • Absolutely agree Victo – the exceptions make the rule and any hope of getting a pry bar under the edge of that data lies in the outliers. That said, after a few thousand hours of pondering I have come to the conclusion that environmental affects and genetic affects are really cut from the same ball of wool, just at different places in the ball. I also believe in genetic memory – more emotional than intellectual(and affecting probabilities rather than absolutes) but definitely motor control (ever see a child repeat the motor habits of a parent, even when they have not met? It’s telling) This means that there could easily be emotional learning transferred to a child that could resist the effects of abuse. To me there are a number of ways that behaviour can be affected: genetic, environmental, learned, and a few others. I think that immunity to the probability of ACE being predictive can come from any of those channels. That being said, i think it would be much more difficult to discover why ACE was not predictive than it would be to discover why it is many cases. And it would be an amazing mystery to solve and so useful to help modify behaviour. What a great challenge. .

        Liked by 1 person

      • That could be taken two ways::1) genetic emotional memory is sexy or 2) genetic emotional memory Paul, you sexy thing you. Bwhahaha! **rolls on floor laughing**

        Liked by 2 people

      • Sorry. “…environmental affects and genetic affects…” should read “…environmental effects and genetic effects…” That’ll teach me to proof what I write.

        Liked by 1 person

  11. Thank you for posting this. I keep saying that child abuse is a community event and this is another example. We are told that we must forgive the person who destroyed our lives and opportunities. And we are told that must forgive the people who let it happen. And we are told that if we feel our anger we are “holding on” to negative thoughts and “not letting go” of the past.

    Liked by 2 people

    • I like what you say about a community event. Absolutely true. Most people are well meaning but do not understand the further damage they create with their words and actions. Then you get those sociopaths like that pastor…

      Liked by 1 person

    • It is no different than with an abusive partner: The optimal way to release one’s abusive past, if one’s parent was abusive, is to “let go” of that parent.

      Ideally, one should at some point, either before or after this, confront the parent, in person, by phone, or in writing, with a description of what s/he did which was abusive, and how this made you feel. The parent will likely express no remorse, but the confrontation will aid healing. Evil should be named. The more of us who call it out, the more light we shine upon it, the less darkness there is for it to scuttle and hide within.

      Liked by 2 people

      • yes…Your comment has prompted me to go ahead and post something I wrote on this topic.

        For myself, I’ve had enough of sitting in silent fear while barbarians break precious lives and torture the victims.

        Real words to describe real crimes.

        Liked by 2 people

      • I just peeked the barest bit at your place, and if there is anything I did that lifts your burden or anyone else’s by the tiniest amount, I thank God for that, and pray that good ripples spread even wider.

        Liked by 2 people

  12. So many people carry such burdens with them and have no one to turn to. Seems to me many of these religious figureheads smell the vulnerability and prey on these people. Even in my outpatient clinic – I have heard some of the most horrifying stories told by foster Moms about what type of situations their Foster children were living in, before they were removed from their biological families. Great, heartbreaking post!!!!

    Liked by 1 person

  13. Good job, Doc.! There is a Rape Crisis Center funded by grants in the medium sized city I live in that offers free support groups and counseling for survivors no matter how long ago it was. Maybe there is something like that available for your patient?

    Liked by 1 person

  14. Wow, yes. I’ve taught that girl dozens of times. Dozens of times I’ve taken her to the counselor at the college or university, or sat with her myself and listened to her explain she has to do the impossible, forgive the man who beat her up, the dad that forced her to drop out of school, the dad who raped her, the husband who abandoned her leaving her without work and pregnant then came back to beat her up. I’ve sent her to the nurse because the bruises on her arms were bad and it was the only way to get the law involved — if she’d allow that. Those are the girl students who meant the most to me, the ones who were fighting for the chance to learn and improve their lives with not one iota of outside support from anywhere and taking abuse for it, too. I’ve even said, I’m sure, “Whatever church you go to, God doesn’t want you or your babies to be beaten by your husband/boyfriend/father. Get out.” Sometimes they did. 😦

    Liked by 3 people

    • I have an answer a worthwhile pastor gave to me, and one that can work on those who take the Bible literally:

      The commandment says to honor your father and your mother. However, the Bible places obligations upon parents. It defines what parents are and what they should do.

      – Did your parents act like parents?
      – Did they act loving toward you? Did they nurture you?
      – Did they hit you for your benefit, or because they were angry, or wanted to control you?

      I don’t believe your parents were ever your father and mother in God’s eyes. Therefore, I don’t believe you are under any obligation to honor them as your father and mother according to the commandment.

      Liked by 2 people

  15. This is one of the many reasons I do not like pastoral counseling. Too often, the abused is exhorted to “forgive” their abusers and admonished that “bitterness is a sin”. I know not all Christians espouse that “wipe the slate of the wrongs done to you, on you, clean” brand of forgiveness, but a lot, a lot, ar least where I live, do.

    Liked by 1 person

    • I try to steer people clear of that sort of counseling, too. One of the other damaging twists I see is the guilt trip of “the reason you have anxiety is that you are not trusting God enough” and they are told to pray harder or read more or fast. Never, ever fixes the problem. Only makes it worse.

      Liked by 1 person

    • Thank you! So much of the Bible is misused, wielded like a club because they are missing the point of what true grace means, how all encompassing it is, and they are destroying lives and hearts as a consequence.

      Liked by 1 person

  16. Reading your powerful post I instantly thought of the Duggar family, who are in the news now because of their eldest son, Josh. He made a big “apology” for his actions against his sisters and unknown other girls, but it all was about him and how Jesus made everything hunky-dory so everything was cool, nothing to see here folks. No mention of any counseling for the girls involved. I’m sure they were told they had to forgive him and probably were told they contributed to it in some way by “tempting” him. Gah!

    Liked by 1 person

  17. Wow! Sometimes I am embarrassed to be associated with “Christians” like this. The poor woman! I heartily applaud your description of such misrepresentation of Christianity as spiritual malpractice. You absolutely nailed it. When a close friend’s baby died, I overheard someone at the funeral telling the grieving parents that “God needed another angel, so he took yours.” Sometimes I utterly despair of humanity in general.

    Liked by 1 person

      • Agreed. What a terrible aspersion on the character of God! I immediately went to the parents, who were my good friends, hugged them both and told them God did no such thing. Sometimes the best words of comfort are no words at all, simply being there is enough.


  18. Dear David–and others: “What’s happened here is horrible, James. A life has been destroyed. I, for one, find no comfort in your comparison. In fact, I find it disturbing.” When I read this story, so well told, I could have cried. Then I thought about what was really going on here for me in this conversation, by the comments being made. I was made so aware that one human was able to talk to another, that all of US here were able to comment, to even question, faith, religion, priests, pastors WITHOUT BEING IN FEAR OF OUR LIVES. Are we willing to continue here in our self-expressions knowing that we MIGHT be being monitored by the thought police? I guess I was so unclear? I wanted to shout out and thank (some) god, God–or the Universe–for what I have, for what the doctor was/is able to do. Am I so obtuse? Anyone ready to trade places with a female doctor in, say, Yemen? Saudi Arabia? Anyone?

    Liked by 1 person

  19. That’s sad. It sounds like she never learned to “forgive herself” (for something she didn’t do wrong in the first place) and felt the need to continue to seek out those who would help her punish herself some more. The bastard broke her. I hope she finally found the strength to move on.

    Liked by 1 person

  20. She must find a new church and someone ought to smack that “pastor” on the nose really hard.
    You don’t let a rattlesnake back in the house just because it didn’t bite this time.

    Liked by 1 person

  21. If I really think about it, there are so many clients that I wonder about and hope they are doing better…
    “No counseling available to her??” Do you not live in a town that has a mental health agency which provides low cost/sliding scale sessions? Is there a town close by that does?? What’s going on in my town is that we are understaffed. I’ve allready seen a couple of clients (and remember, I’ve only worked 2 weeks at this agency) come into crisis because they weren’t able to get in to see a therapist until next month. =(

    Liked by 1 person

    • This was over ten years ago and no, there was nothing of the sort available. This was not a major metropolitan area. Now it is an FQHC and they are able to offer dental and counseling/psych for patients, or so I hear.

      Liked by 1 person

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