“I told myself I was tough”, she said.

“I told myself I was strong enough to stand by him”, she went on. “He has a troubled past and I understand why he might…”

She was no doubt tough. She had come into my office with her boots authentically worn from long days and dust. She placed her wide brimmed cowboy hat on the side table revealing her face with lines etched by the sun. Her long sleeve button down shirt was tucked into pressed dark denim Wranglers adorned by a silver belt buckle. She told me about her horse who had been her companion for the past fifteen years, her cow dog, and her days counting cattle and mending fence. She said she preferred solitude and despised being the subject of pity. “I have never been to anybody like you before”, she said. “It just never felt right to complain”, she continued while she shook her head and stared at the office floor.

At the time, as a bonafide ‘beginner’ in my profession, I couldn’t help feeling intimidation, respect, admiration, and curiosity all at once. She exuded an old-fashioned wisdom and grit softened by humility.

She told me about her anxiety. She told me that she could generally escape the worry amid daily demands on the ranch and with the freedom she felt on her horse’s back navigating endless acres of high desert and sage.

Inevitable aging and the toll of ranch life had forced a slow-down. She told me two much younger ranch hands were hired and the herd was downsized, which offered a reprieve, but also more moments of stillness seldom available in the past. Distractions became fewer and God help her, she was not going to get one of those “darn smartphones”. The opportunities to bury the day’s worries in hard work became scarcer.

For a long time, the story she told was not being able to overcome the tightness in her chest, the pit she felt in her gut, the lost “pep in her step”. She avoided using words like ‘sad’ and ‘afraid’ and often apologized for “bombarding me” with so many problems despite my repeated reassurance.

At times, she exuded suspicion and stubbornness when we discussed strategies and ways to cope. Nevertheless, her attendance week after week did not waiver.

One week, nearly six months into our work together, she sat down on the couch as always, put her hat on the side table as always, and then tears fell. Most always armed with stoicism and a ‘safe’ emotional distance, her tears caught me off guard. I attempted to gently inquire knowing that this was a pivotal moment…

“Can I show you something?” she said. I nodded with equal parts encouragement and concern.

She unbuttoned the cuffs on her shirt and with tears still falling rolled up her sleeves.

She held out her bare forearms discolored with visible shades of blues, reds, and purples and then stated, “there’s more”, and she slowly removed her shirt. Trying to hold back the intensity of my own emotions, I stood up from my chair, put a hand on her shoulder and could only think to say, “you are safe here”.

I scanned her upper body etched in bruises and redness- up and down her arms, the contours of her back, the base of her neck, along her ribs. Amid the damage, I couldn’t also help but notice her physical strength and stature that seemed to be in such stark contrast to the violence forcefully inscribed all over her body.

He had been described as an “old cowboy who liked whiskey”. He had been a Vietnam veteran almost certainly haunted by the trauma of war. She told me his rages would come without warning and she would become his target. Sometimes months would go by without incident. Accusations of infidelity, belittling, and name calling would escalate into punching, pushing, kicking, and hair pulling.

Afterwards there was usually an apology and sometimes a letter with promises never realized. Enduring the fear of staying was somehow lesser for her than facing the fear of pity and a future unknown. She tried her best to see her tolerance as toughness and in the lonely moments, found bits of reassurance riding out to her favorite viewpoint and taking in the beauty of the land when all else seemed so ugly.

I was the first person she told. Amid her desperation, I withheld my temptation to respond with a directive to ‘leave’ as it is almost never that simple. As she stood in my office exposed, vulnerable to the core, and overwhelmed with uncertainty, I struggled to find words. So instead, I could only say to her what was most evident to me… “I have never seen you so tough” and this I repeated week after week as we navigated the journey ahead.

This story is in honor to all the men, women, and children who have experienced or have been witness to domestic violence. 

Details of this story and names have been withheld due to confidentiality. Client consent was granted prior to publication.

Thank you for listening.

With gratitude,

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC

Sisters & Silverton, Oregon, www.shesoarspsych.com

In my job it is an undeniable fact that legislation and policies directly impact the emotional well-being of my clients and admittedly, myself. Amid our national division and contention, many of my clients have reported feeling powerless, disheartened, silenced, and unnerved.

With suicide rates, depression, and reported levels of stress on the rise, it is short-sighted to blame rising mental illness only on individual pathology rather than acknowledge the societal systems and policies reinforcing our national unrest.

In my work, the majority of my clients are women and girls. My youngest client is 5 years old while my eldest are in their eighties. I have the privilege of hearing stories across generations, backgrounds, faiths, and political beliefs. While each client is unique, the themes of powerlessness, trauma, and self-doubt resurface again and again.

I would consider myself to be a ‘woman in between’. Perhaps I can blame this on being a classic, peacemaking middle child where a slight bit of resentment lies, but wherein also lies the need to methodically evaluate both sides, appreciate nuances, and an unrelenting curiosity to know somebody’s story.

I resent labeling and believe labels can often be limiting. I think I might subscribe to the “common sense and decency” political party if I ever thought that could exist in politics. I prioritize my faith and spirituality, but have difficulty committing to any specific set of beliefs. I enjoy brief urban excursions where I pretend to be a version of hipster and fancy, but I feel most at home in the solitude of sagebrush and mountains. I worry daily about the wrong people having access to firearms but relish the chance to be hunting in the wilderness with my rifle on my back. My playlist is varied: from hip-hop to alternative to country. I am a ‘woman in between’ and when it comes to abortion, my opinions are scattered on both sides of the fence. I don’t like it…I think it is sad, but I also think that women and girls far too often find themselves in places of desperation, powerlessness, and self-preservation that unfortunately make the tasks of carrying a child and motherhood daunting, if not seemingly impossible. And so, for too many women and girls, deciding whether to follow through with pregnancy or not comes down to survival on a physical, psychological, and spiritual level.

Women and girls have for far too long been well acquainted with the feeling of powerlessness. This past week alone I think I sat with five clients of all ages who for the first time disclosed being sexually assaulted. Additionally, women frequently describe feeling taken advantage of in other ways- at their workplace, in the home, and the many times that others have tried to capitalize on their gifts of hospitality and empathy. As a provider, you develop unique ways to empathize while also guarding yourself from the emotional intensity. Every so often, the heaviness hits and I find myself escaping to the woods, blasting my music on random back road drives, or exhaling my frustration to be beat of my horse’s hooves.

What unsettles me most is how our autonomy as women continues to be threatened. Women around the world continue to battle for the right to drive, the right to choose their partner, the right to express their sexuality, the right to consent, and the right to financial decision-making. We have been seen as property, as inferior, as hyper-emotional, as objects. While in some parts of the world there have been great gains, in others time seems to be standing still.

Unfortunately, in the United States, having a child can be one of the greatest threats to our autonomy.

For too many women, having a child poses considerable risks. While these risks may be more or less present depending on the woman, they should not be dismissed or ignored while we try to safeguard the lives of the unborn but do little to address the systemic pressures creating these endemic risks in the first place.

Here are the facts:

1. The United States has the highest maternal mortality rates of any developed country.
2. While other developed countries have seen a steady decline in maternal mortality, mortality has increased in the United States.
3. Black women have a maternal mortality rate 3 times higher than white women.
4. Only 13 percent of mothers have access to paid leave.
5. While men are known to make an average of 6% more on their paycheck per each child, women are known to lose 4% per each child.
6. Throughout the country, the annual cost of infant childcare can be equal to if not more expensive than a year of college tuition.
7. Nearly half of all women who have abortions live below the federal poverty level.
8. 1 in 3 women will experience sexual violence in her lifetime.
9. Postpartum and mental health supports are lacking nationwide.
10. Abortion rates in countries with the most restrictions are higher (37 per 1000) versus countries with the least restrictions (34 per 100).

Perhaps the questions we should be asking are: How can we come together to minimize these risks? How can we make motherhood less daunting? How can we honor the unborn, but also prioritize the health and wellness of future mothers? Are we holding men and boys as accountable to the fate of our unborn as we are women and girls? It seems that men can abort their responsibility as fathers without legal consequence- is this fair? How are we addressing sexual violence? What about poverty, parental leave, mental health supports, and affordable childcare?

Ultimately, the abortion debate has simply been another opportunity for division, sweeping generalizations, and ‘otherizing’. The concept of addressing root causes that so significantly impact the health of mothers, children, and families might, despite the contention, hopefully bring unity.

“For every effect there is a root cause. Find and address the root cause rather than trying to fix the effect, as there is no end to the latter.” -Celestine Chua

Thanks for listening everyone.

With gratitude,

Audry Van Houweling, Owner, She Soars Psychiatry, LLC

Sisters & Silverton, Oregon

www.shesoarspsych.com