Select Page

When the inner Jericho walls crumble

This piece explores the tragedy of the Dickason murders. Psychology can help us understand how to prevent tragedies such as this one. But, because parental violence against the young is such a scary field, the help that is available often doesn’t get used. Also, some people in the news media misunderstand the role of psychology and, therefore, do not make these helpful approaches known. Trying to understand what is behind a tragedy such as the Dickason murders doesn’t mean murderous behaviour is absolved. Rather, it illustrates how understanding maternal post-natal depression and psychosis can hopefully prevent similar tragedies.

When the inner Jericho walls crumble

What happens when we do not get the necessary help while experiencing emotional overload?

Typically, emotional distress affects our performance.

Upset in a child or student’s immediate family can show up in lower marks or even in a fail. Many a student drops out when external turmoil sparks a depressive, inner response.

But, some among us construct an elaborate internal intellectual defence edifice against strong, difficult feelings. This inner set of Jericho walls helps to boost achievement in difficult times which sees others falter.

Problem is difficult feelings don’t go away. Inner turmoil cannot be wished away forever. Ultimately, it breaks through, whether one recognises it consciously or not.

Emotional overflooding reaches its high mark in our solitary activities, such as studies and sleep. It corners us when we are isolated and emotionally overburdened and overstretched.

Many of us reach out for help when there is overload. Those who have been suppressing their feelings forever may not trust help.

We see that when we follow the tragic story of Lauren Dickason who fled unrest here, in South Africa, and succumbed to her own, internal demons in September 2021 when she killed her three young daughters.

It was similar, too, when Manuela Costa, like Lauren also a general practitioner, killed two of her four sons in 1998 (two survived and were sent to an uncle in Portugal while Manuela faced the law).

While Lauren has just been convicted for murder in New Zealand, Manuela’s South African legal team managed to get her freed. They succeeded in convincing the highest authorities that she was psychotic when she killed her sons.

There are many similarities and differences in the two cases. What stands out for me is that these two women were general practitioners who must have ministered to many patients with emotional problems. They were both married to men who specialised in the medical field. Graham Dickason became an orthopaedic surgeon and Jose Gil a psychiatrist.

None of the four seemed able to use psychological help while having to look after their young families. That is apparent for me, especially in the Dickason case, because Lauren’s many signals of being in emotional trouble were not taken up as warning signs and treated (many of her messages were mentioned in reports).

Manuela and Jose had four sons in quick succession.

At the time that Manuela injected her sons with drugs and set her house alight, Jose had been dead for two years. He apparently committed suicide while under suspicion for medical aid fraud.

In addition to losing Jose through divorce and death, Manuela had lost her own mother and had to deal with breast cancer. She set her house alight two days before it would go on auction.

Lauren had help with infertility, a miscarriage, as well as three young children, one of whom had a harelip that had to be surgically fixed.

We know very little about Graham, as Derilene Marco pointed out in the Sunday Times of 20 August 2023. While nobody has indicated why he missed all his wife’s signals of distress it is probable, I think, that his internal Jericho is still standing triumphantly tall.

In the field of psychoanalytic psychology in which I work we know families with multiple children which follow each other closely in age is like a red flag for budding disaster. That such families can really benefit from therapeutic input.

Infant mental health and postnatal depression studies and practices undergird the importance of emotional support for all concerned, especially the primary caregivers who are often the mothers.

Multiple struggles, including multiple losses (which also cover divorce and emigration, two high stressors), also indicate the need for therapeutic help lest unacknowledged rage boils over.

The Dickason and Gil-Costa cases are reminders that disasters that could have been prevented so often happen before they can be stopped.

Especially these two cases are a reminder that medical training itself is often defended against strong, difficult feelings. That medical students face a relentlessness in their training that doesn’t encourage them to stop and take emotional stock.

In those who are already very defended, their inner set of Jericho walls might seem impenetrable and safe. Yet, we are all vulnerable and frail as humans. At some point our manic defences will crumble. Unattended depression will implode and explode. If not checked, tragedy may follow.

It is my sincere wish that these two tragedies will spur us on to taking help when needed rather than scorning psychology as a crutch for the weak. The moment we want to name and shame others rather than face ourselves, we need to stop, we need to pay attention to what it is that we are trying to keep hidden.

On baby rape

This is an edited version of a 2013 opinion piece originally written a day after a six-week-old baby was allegedly raped by her young uncle in Kimberley’s Galeshewe township. As this happened, matrics across South Africa who were sitting their final exams had to deal with a very problematic question in their set work, Tshepang. Tshepang is a play about a baby rape that took place years before in Upington which, like Kimberley, is in the province of the Northern Cape. The question in the matric paper required learners to describe how they would use a broom and a bread to illustrate the rape of baby Tshepang.

The past few days brought reports of two baby rapes and a polemic about the question in the matric drama paper about the play, Tshepang, which more-or-less coerced learners to heighten the horror of baby rape, setting a scene with bread and broom.

The rape of a six-week-old baby girl in Galeshewe, Kimberley, had the Minister of Health, Aaron Motsoaledi, pronounce on the “unspeakable”. Describing himself as a “broken man” after hearing the news of this rape, he recollected surgically fixing a young girl’s internal injuries after a rape years ago. At that time, Motsoaledi said, such rapes were not talked about.

According to an editorial in The Star newspaper, which highlighted the Galeshewe rape on its front cover on 28 November 2013:

“Another child has been raped. As you read this, she is fighting for her life in an intensive care ward in Kimberly, Northern Cape. We think she might be the youngest rape victim ever recorded – she is only 6 weeks old.

“Baby Tshepang was 9 months old when her mother’s boyfriend raped her in Upington in 2001. She was dubbed Tshepang (Hope) by the sisters and nurses in Kimberley Hospital, who fell in love with her spirit.

“Now, 12 years later, staff at the same hospital have to do it all over again as we, as a nation, try to make sense of what happened.”

The other baby rape, reported by News 24 online, took place in the Western Cape when a mother left her infant with a man she knew as she went out. At the time of writing this it was not possible to find more details about this incident which seemed to have all but disappeared in the publicity surrounding the Galeshewe incident and the matric drama paper. A feature of all three baby rapes mentioned here is that the male perpetrators are known by the mothers of the children.

Times Live reported that the 24-year-old uncle of the Galeshewe girl threatened to kill her even before she was born. He told his sister he would “kill her, the baby and himself,” according to Northern Cape premier Sylvia Lucas. According to Times Live the baby’s mother (22) and uncle are orphans, taken in by their grandmother on whose property the rape took place.

Meanwhile Lara Foot, the Cape Town playwright and author of the play, Tshepang, condemned as “inappropriate” and “appalling” the exam question mentioned above, according to The Star. The newspaper quoted Foot as saying “the question is unsuitable and entirely problematic in that it appears to miss the stylistic choices of my play”.

At the same time, though, Kwa-Zulu Natal drama lecturer Peter Mitchell dubbed the question “creative”, according to News 24 who reported him as saying: “It is a creative question about how you would get an actor to portray the rape in a non-realistic way, but still portray the horror of the situation.”

According to a report in Times Live the Red Cross Memorial Hospital in Cape Town “found that between 1991 and 1999 nine infants under the age of one, 15 toddlers younger than two and 27 under the age of three were admitted for injuries resulting from sexual abuse. This was mentioned in the doctoral thesis of social worker Amelia Kleijn who explored what drove men to rape children younger than three years.”

The newspaper reported Kleijn as saying such acts were out of revenge and that the men who perpetrated them were “… subjected to very, very high levels of what I could call physical abuse. As children the men were surrounded by drunken bullies, they never had positive role models, they experienced violence at home and in school. When children live with that amount of violence it becomes normal. By the time they are adults that is how they experience the world, as a very violent and a very frightening place.”

Kleijn’s study highlights the outside reality that produced the perpetrators of baby rape. The task facing psychology is to understand the inside or emotional worlds of men who wreak their revenge in this way.

Internationally renowned psychoanalysts Otto Kernberg and Arnold Goldberg write on how perpetrators of the unspeakable are put together psychically, on how their personalities are formed. According to Kernberg paedophilia and incest – which is how the Galeshewe and Tshepang incidents can be categorised – are types of behaviour that are very resistant to intervention or change. People who perpetrate acts like these may never have developed a conscience which makes it very difficult to treat them. They have to be kept away from society (in mental institutions or jails). Goldberg describes how the personalities of people who sexually torture and mutilate others are shaped. They seem to have two, parallel personalities. The one personality is like a Dr Jekyll who seems to be normal and can deal with the world. The other personality is like a Mr Hyde who feels inadequate, vengeful and perpetrates the unspeakable. In addition, Johannesburg psychologist-trainer Coralie Trotter, who lectured groups on perverse behaviours in 2013, explains that most people repress the very strong emotional impulses they have as young infants. It seems people who perpetrate acts like rape may not have managed to repress these impulses.

The exam question and the Northern Cape premier’s comments on the Galeshewe rape provide material that can help us speculate on these specific instances. Using the explanations provided by Kernberg, Goldberg and Trotter about perverse behaviours it seems evident, as mentioned above, that perpetrators of baby rape never repressed their extremely violent, and even murderous, infantile feelings. They displace these on the vulnerable infants in their environments. Because their rage is infantile, they do not keep reality in mind. They perpetrate against the most vulnerable trying to get rid of what feels fragile and broken in themselves.

In the case of the Galeshewe rape we seem to be dealing with an older brother and younger sister. It is possible that the brother might never have forgiven his mother for replacing him with his sister and that his mother never realised how important it is to address his murderous sibling rivalry. We could say that we see a man who may look like an early adult but is really a raging toddler at an emotional level. He unconsciously mixes up his mother and sister and wants to act out his rage that his mother got pregnant years ago and he could never again have his mother focusing only on him. In mixing up his mother and sister and he also takes revenge on the baby born years ago (his sister) by attacking his sister’s young infant. He gets right inside the baby as he would have wanted to get right inside his mother – to destroy what she carries inside her body.

The reported exam question also seems to illustrate this, as if the person who set the question had this kind of scene in mind: the uncle damages the infant’s insides; the broomstick seems to be meant to go inside the bread (baby).

Before we acquire and start thinking in language, we see images and “think” in images. Freud called this primary process thinking. When images that compel enactment dominate, when the words that go with them are somewhat divorced from them, then we are probably dealing with something very traumatic that happened in the earliest years of life. An enraged, deprived and envious individual obsessed with early images of violence may rather act than think, like in Galeshewe.

Premier Lucas helps us make meaning of what happened pointing out the threats. It is clear nobody connected the dots between the words and the action before the rape took place, possibly because for many such acts are unthinkable. Nobody believed the infant girl’s uncle would follow through on his threats. They might have thought them empty threats.

Whether we find out who set the fateful exam question or not, what is apparent is that the questioner also has disturbing images uppermost in mind. Strangely, this matric question seems to want to copy or re-perpetrate Tshepang’s rape. The victims are the drama students across the country. What is ruptured is their ability to focus, to concentrate in a time they need it most. As if the setter of the question is disturbed, so disturbed that it has to be pushed into the minds of many. There is something horror-filled in the use of the bread: on the one hand it makes the act innocuous, on the other it gives us a sense of how much the questioner wants to get right into the object. The broom speaks of wishes to torture and mutilate the insides of a helpless infant, in or outside of the mother’s body.

The question setter is displaying a phenomenon that child psychoanalysts Melanie Klein and Hanna Segal called symbolic equation. Whilst pretending to be symbolic, the so-called symbols are actually very concrete: the bread becomes-the-baby(-becomes-the-mother’s-body), the broomstick becomes-the-penis. In psychological terms we would say the exam question is an enactment of the rape, not an attempt to further understanding. And, that is why people are in an uproar. It is not necessary to repeat the horror of the situation to get the point across. In this, one could say, the question setter is as coercive and violating as the rapist.

In their very courageous and moving article, “The farthest reaches”, published in volume 21, number 1 of Psycho-analytic Psychotherapy in South Africa, psychotherapists Frances Williams and Sharon Sibanda write about their harrowing, but very necessary work with young victims of rape. They describe the psychic collapse that follow violent bodily intrusion.

For perpetrators of rape the process is perhaps somewhat different. Even though they might have been victims of sexually inappropriate acts by others before, they have become identified with their aggressor (or it is even possible that they have a felt sense of wrongdoing and act on it). Perpetrating similar acts against victims that are possibly as vulnerable as they were once may keep them psychically intact. They do not have to sit with the unbearable feelings inside of them. They violently force themselves into others.

Perhaps Cape Town poet and academic Gabeba Baderoun, who recently launched her book Regarding Muslims, fills out another part of the perpetrator picture when she reminds us that in all the many years of slavery in South African not a single slave subjected to sexual abuse from a master or owner received help as far as she knows. Baderoun says South Africa has a history of sexual violence which looms really large, but which we seldom acknowledge.

This opinion piece was used by the Gauteng Association of Infant Mental Health (GAIMH) on their Facebook page in 2013. TherapyRoute later republished it.

Bell and Bell: An expose of the Tavistock’s top management and GIDS’ suppression of concern and criticism

When children diagnose themselves

“When doctors always give patients what they want (or think they want), the fallout can be disastrous, as we have seen with the opioid crisis. And there is every possibility that the inappropriate medical treatment of children with gender dysphoria may follow a similar path. Practitioners understandably want to protect their patients from psychic pain. But quick fixes based only on self-reporting can have tragic long-term consequences. And already, a growing number of trans “desistors” (also known as detransitioners) are seeking accountability from the medical professionals who’d rubber-stamped their trans claims.”

(Marcus Evans, “Why I resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just ‘Affirmation’ and Drugs”, published on 17 January 2020 in Quillette.Com)

For three years renowned psychoanalyst and psychiatrist David Bell (70) was in trouble with top management at the Tavistock and Portman National Health Service (NHS) Foundation Trust for blowing the whistle on questionable practices in its Gender Identity Development Service (GIDS).

A high court judicial review of the GIDS in England in December 2020, brought by Bell-namesake Keira Bell (23), “ruled that children under 16 were unlikely to be able to give informed consent to receive puberty blocking drugs” (The Guardian, 6 December 2020).

Soon after, in January this year, the older Bell – under constant threat of disciplinary action by his bosses – retired. He is now free to talk openly about these issues, according to a The Guardian interview with him on 2 May 2021.

The December 2020 Bell versus Tavistock court decision ruled that “referrals for the drugs and cross-sex hormones for under-16s will be permitted only when approved by the court” (see the document online: www.judiciary.uk, titled Bell -v- Tavistock judgement – Courts and Tribunals Judiciary).

The younger Bell was a recipient of a GIDS medical intervention from 16. She received puberty blocker drugs and had a mastectomy in her then-quest to become male (read her account of her transgender journey and eventual decision to de-transition: www.persuasion.community, titled Keira Bell: My Story – Persuasion).

The Tavistock appealed against the high court’s December 2020 decision and its appeal will be heard this month.

Meanwhile the British Care Quality Commission (CQC) in January 2021 gave GIDS its lowest rating, “inadequate”, which according to the BBC News means “it is performing badly” (“The crisis at the Tavistock’s child gender clinic, 20 March 2021). The BBC News also reports that the National Institute of Health and Care Excellence (NICE) found low evidence for the hormonal treatment of “young people struggling with their gender identity” (“Evidence for puberty blockers very low, says NICE”, 1 April 2021).

In his interviews with The Guardian and BBC News the senior Bell noted that all the information that emerged in the course of the high court case – such as that GIDS and the Tavistock could not provide factual evidence for its reliance on trans-ideology-based interventions – has yet to have an effect on how the Tavistock manages and GIDS executes its mandate. From 2015 onwards, as referrals to GIDS mushroomed and young girls became almost two thirds of the referrals, a number of reports that investigated this dilemma were made available and were almost all quashed.

Towards the end of last year the NHS “announced an independent review into gender identity services for children and young people … which GIDS supports” (“The crisis at the Tavistock’s child gender clinic”, BBC News, 30 March 2021). This review is led by Hilary Cass, a former president of the Royal College of Paediatrics and Child Health. The outcome of the Cass Review is still awaited.

Bell, former Tavistock board member Marcus Evans and Kirsty Entwistle who worked in the Tavistock’s Leeds service are among the clinicians who left the Tavistock’s service as a result of GIDS’ practices. They have been speaking up about what can be seen as the extinguishing of the talking cure in GIDS. They mention how labels of transphobia are liberally handed out when anyone dares to speak out. This silences healthy scientific information-gathering and debate.

Bell also made mention of how the lawyer whose services he started using when top management started clamping down on him warned him against sitting on information of harm and not disclosing it. After speaking to ten GIDS colleagues who implored him to do something, Bell wrote a report in 2018 which his superiors kept from many. His lawyer told him: “ … on the contrary, a failure to send it out might make him culpable in the event of any further legal case taken against the trust” (The Guardian, 2 May 2021). In addition to refusing to remain quiet about the disquiet of his colleagues, Bell also launched two crowdfunding drives to pay his legal costs.

Among the leading lights in psychoanalysis who highlight problems with what is called a gender-affirmative approach is Alessandra Lemma who, like Evans in The Guardian, puts forward a treatment model for children and adolescents with trans ideation (“Trans-itory identities: some psychoanalytic reflections on transgender identities” in The International Journal of Psychoanalysis (2018), 99 (5), pp. 1089 – 1106).

All of the clinicians named here make reference to how internet sites, such as Mermaids, push the trans-ideology. Fragile children and adolescents, who often face multiple mental health issues, get stirred up by the trans-ideology solutions offered on these sites. In her piece on de-transitioning Keira Bell also mentions how an alternative site helped her understand she had other options.

Mermaids is a trans-ideology charity while Transgender Trends is a charity that insists that no child is born in the wrong body.

If you Google Mermaids, you will also see how the national lotteries board in England investigated the GIDS issue to see whether it should let Mermaids receive a large lump sum with which to fund GIDS. The funding relationship between GIDS and Mermaid is mentioned often in the different news articles quoted here. It is said to cloud the judgement of the powers that be.

This article was the lead in SAPI News 5 of June 2021.

Deon Wiggett’s brave act of social activism helps scores of men

Former advertising copy writer Deon Wiggett spent a substantial part of 2019 tracking down and finally getting apprehended the man he alleged raped him at 17. Since Deon’s expose of former media executive Willem Breytenbach another 40 men claimed he sexually abused them. The youngest victim was reportedly 12 at the time of his ordeal (News24, 3 February 2020).

MyOnlyStory.org chronicles Deon’s brave campaign which is narrated in four podcasts. The website also gives access to pertinent interviews. According to news reports Deon is currently working on a book which will be published towards the end of this year.

Deon’s exposure of Willem Breytenbach, who will make a court appearance again on 26 June this year (News24, 30 March 2020), is comparable to that of Harvey Weinstein in America by the #MeToo movement (TimesLive, 5 December 2019). On 11 March this year, Weinstein was sentenced to 23 years for sex crimes (New Yorker, 12 March 2020) and he started his prison sentence soon after.

While Weinstein was accused of sex crimes against scores of actresses and women working in the American movie industry, Breytenbach apparently preyed on boys and young men working on school and other newspapers. When News24 published the first podcasts, Breytenbach closed down the media agency he was running for some time (3 February 2020). At these online businesses, called Lumico and Lightspeed Digital Media, Breytenbach stands accused of allegedly abusing nine employees. Breytenbach’s former businesses ran publicity campaigns for well-known South African singers, amongst other things.

In his podcasts Deon relates how he encountered Breytenbach at a time when he was involved in a school newspaper and Breytenbach ran the school newspaper project for Media24. Breytenbach not only taught Deon the school newspaper business, but also Adriaan Basson, now the editor-in-chief of News24, and Waldimar Pelser, now the editor-in-chief of Rapport. It is to the credit of these scribes and Deon – and Deon insists his psychologist, Craig Traub – that Breytenbach was stopped in his tracks (see the coverage in News24 end of 2019).

Deon generously gave us permission to use the logo for his website here. “Go right ahead – the podcast was created to help people,” he wrote in his email to me.

I am highlighting Deon’s bravery and the bravery of the journalists and Deon’s psychologist here because we need to applaud a new generation of men who don’t close their eyes to the sexual abuse of boys and young men. The exposure of Harvey Weinstein in America was big. The exposure of Willem Breytenbach in South Africa is big.

Recently I wrote an opinion piece which was published in Psychoanalytic Voice, the Facebook page of the South African Psychoanalytic Confederation (SAPC). In it I said that the almost primordial initiation practices at schools like Parktown Boys High and the botched circumcisions in the Eastern Cape and other areas in our country which leave scores of boys dead, mutilated and psychologically affected need to be highlighted and changed. Across all our communities we need the men of today to stand up against abusive practices which beget further abuse.

We cannot keep sacrificing boys and young men in a kind of lawless Greek tragedy that never ends.

We need more people like Deon Wiggett and the team who supported him to turn the tide of violence in our country. I salute them. I encourage all of us to salute them. Their sacrifice is generative and creative and it builds rather than destroys.

*First published in the South African Psychoanalytical Initiative Newsletter, Issue 1.