The three captive women held for a decade in Cleveland, Ohio were treated every year to a particularly perverse gesture by their captor in the form of a cake. "He would celebrate their abduction day as their new birthday," according to a cousin of one of the victims. It is just one detail of the flood emerging after their rescue on Monday - a cynical symbol of the psychological trauma the women suffered through a decade-long ordeal of horror.
The crass celebrations were in addition to rape, repeated beatings, starvation and death threats that the women told authorities they were subjected to, according to a police report obtained by The New York Times, CNN and other news organisations. Ariel Castro, 52, was formally charged Thursday with four counts of kidnapping and three counts of rape in a Cleveland courtroom one day after two of the women returned to their family homes.
In one of the most shocking details, he allegedly starved and beat one of the women to force her to miscarry five times - deeds for which he could even face the death penalty, a prosecutor said. While two of the three women who returned to their family homes were given joyous receptions on Wednesday, people who have worked with abduction victims say they face a long and possibly difficult recovery. But there is hope that they will regain their lives.
They explain that the reason they didn't try to escape has to do with the amount of psychological trauma they suffered. "There is only so much trauma that the human brain can tolerate," according to International Center for Missing and Exploited Children (ICMEC). People who are abducted "figure out how to survive" when they are threatened, terrorized, brutalised and told that if they tell anybody or try to get away, they will be killed and their families will be killed.
The ICMEC said one of the women in the Cleveland case, Amanda Berry, did a remarkable thing when she escaped on Monday. The centre points out in a statement on its website that adults in similar circumstances haven't always tried to escape. It sites the bank robbery that led to what came to be known as the Stockholm Syndrome, which entails hostages identifying with and supporting their captors.
While some psychologists speculate that Stockholm Syndrome figured into the scenario in Cleveland, others refer to post traumatic stress disorder (PTSD). "While we can't predict each of their trajectories, PTSD is among the most common psychological difficulties following such repeated traumatic events," said Norah C Feeny, a professor in the department of psychological sciences at Case Western Reserve University in Cleveland.
PTSD is a problem among some soldiers returning from combat, and in recent years it has become much better understood. Feeny said humans are very resilient and even following events like rape and combat, many men and women do not develop PTSD and of those who do, most go on to live healthy productive lives.
"Most important right now, these women need time and space to re-connect with their families, to begin to reconnect with their communities and rebuild their lives," Feeny said in an email response to questions submitted by dpa. The journey will be different for each of them. If they need therapy further down the line, there are both talk- and drug-based treatments for PTSD, she added.
Ernie Allen, president of the ICMEC, agreed that the women might suffer from PTSD, adding that there were "world-class health care options" available to them in Cleveland, including a new treatment called trauma-focused cognitive behavioural therapy. "If these kinds of interventions are provided in a fairly quick way, a lot of these victims get better," Allen said in an interview with dpa. "The challenge is you have to be patient and you have to have realistic expectations."
The women will have to overcome numerous challenges, some unexpected, such as the way their relatives and friends treat them. They tend to be frozen in time in the eyes of their loved ones, Allen said. Also, they have to relearn how to cope with a situation that is not all-controlling. In some cases, long-term kidnap victims come out of it with a strong commitment to engaging the public on the issue of missing children. Jaycee Lee Dugard of California, Natasha Kampusch of Vienna and Sabine Dardenne of Belgium all have written books about their horrific experiences.
"Our view is, you take it a day at a time," said Allen. "You seek to achieve a kind of new normal." They also will have to handle interviews, if they choose to speak to the media, and get through the police investigation and trial. "There's not a shot for this; there is not pill for this. It's not something that will be over in five sessions," Allen said, but he added, "A whole bunch of these kids get better."