One afternoon eight years ago, Cathy Kezelman, now 58, found herself standing at The Gap, teetering on the edge. She saw herself falling, and visualised the landing. Would it be on the rocks or in the sea? It was a windy day. The waves gnashed below but Dr Kezelman heard little. "I was terrified," she says. "But the pain was so extreme, I didn't know any other way to stop it."
It started a few years earlier, when Dr Kezelman, a GP in Sydney's eastern suburbs, began having recurring nightmares. "One was of me as a little girl being chased through the jungle, footsteps thundering behind me, getting closer and closer. Another was me as a girl being fed like a piece of timber into a circular saw."
The dreams, she later learnt, came from her childhood when, between the ages of four and 14, she had been repeatedly sexually abused by her father and a family friend. "For 30 years I'd repressed it," says Dr Kezelman, who is now the president of Adults Surviving Child Abuse. "I'd compartmentalised it, and now it was coming back to overwhelm me."
Victims of child sex abuse experience a fury of emotions, including shame, guilt, anger and betrayal. "Anger at themselves for letting it happen, anger at their parents for not protecting them," says a psychiatrist, Peter Klug, who has worked in the area for 25 years. "And shame because they feel they might've been complicit, by accepting gifts or favours from the perpetrators."
But the deepest wound is primal and instinctual: it comes from suffering what humans fear most: losing control. "Paedophilia is a dominant/submissive dynamic,'' Dr Klug says. "The child has no control, so they experience the abuse with fear, anxiety and severe helplessness.''
Thus child sex abuse becomes, in Dr Klug's words, "a factory for mental illness". It plants a seed of rot in the soul. Children develop coping mechanisms that destroy and distort their personalities.
"I became scary to other people," Dr Kezelman says. "I was cut off. I made friends but not of any great depth. I would snap at people when they talked of their childhood because mine was a blank. I hated myself for the things I'd done as part of the abuse. I was defensive and harsh and impatient, especially of vulnerability."
As a child, she regularly suffered significant injury but was never allowed to complain. "The family script was: 'nothing happened.' Everything was OK, even when it wasn't.''
Later this became her daily reality. "A couple of years ago I had root canal surgery and the dentist overheated the diathermy instrument. It ended up burning a large section of gum, which then had to be repaired. During the surgery I sat there in excruciating pain and said nothing because I was used to being in pain and saying nothing."
Victims often don't disclose the abuse for fear of not being believed. They're children, after all, and children tell tales. For fear, also of being blamed, or worse, shunned.
So they live in silence with the guilt. Guilt that they are gay (if it was homosexual abuse), guilt for not having spoken up, guilt that they might have, in certain circumstances, enjoyed it. "We see that with victims who come from affectionless environments," Dr Klug says.
"I felt it killed me," a patient of Dr Klug once said. "I've found solace in drugs.'' Now in his 40s, the man had been abused at school by a priest: "He told me that Jesus was gay, and that it was OK to love another man."
Now he lives alone. "I don't shun human contact," he says, "but I don't embrace it … I like the company of women but I can't have an intimate relationship. I prefer the company of my dog.
''I don't like walking outside. I feel people looking at me … that they know I am dirty. I live off the beaten track," he says. "A place where no one knows me and no one bothers me."