In Not My Secret to Keep, we first meet Digene Farrar in her early 40s, at the cusp of realising her professional dream. Nursing and running a business had been an occupation over the years, but modelling was a career she had really wanted to pursue. Against stiff competition, she wins a magazine contest that takes her to New York with a year’s contract. Life had never seemed so good. But not long after settling into her Manhatten apartment, a jet crashes into the North Tower of the World Trade Center. Her nursing training kicks in, and she runs to the scene to offer help, only to become a part of the trail of destruction. In the wake of this indescribable tragedy, Digene begins to fall apart – processing not only the horrors of that day, but those of sustained sexual and physical abuse she’d experienced growing up.

Digene tells her powerful story through a series of diary extracts, bringing us close to her mind as she fell apart and put herself back together again. She begins in May of 2001 and chronicles events over the best part of a decade, which include the agonising processing of early trauma she experienced as a young child and infant. We learn very little about her adult life prior to her early 40s, only references to how her defences got her through her years up until then: those of self-reliance, avoidance of intimacy, denial and self-recrimination. The trauma of 9/11 seemed to puncture these well honed survival tactics, and we journey with her through the painstaking process of making sense of all that she was defending against.

Trapped in New York City after the Towers fell, and unable to return to her possessions in her apartment, Digene desperately tries to find a secure base. It is hard to find and she walks for hours around the chaos, disoriented and not knowing quite who to turn to – just as she felt when young. Her husband Jack is miles away in their marital home in Seattle and when eventually she makes it back, she notes ‘Now that I’m home, I know I’m safe, but nothing seems real anymore’. As the literal dust settles in New York, and the collective mourning begins, Digene begins to experience flashbacks, nightmares and high anxiety, and understandably sinks deeper and deeper into a depression. When Jack begins to despair, she realises she needs help.

So Digene seeks therapy – unfortunately her first therapist she meets isn’t a good fit. ‘Her awkward questions prompt my retelling the story of that painful day, but my emotions have flatlined like the heart monitor of someone whose pulse has stopped. I feel as if part of me is sealed in a cocoon, and the result is total numbness. I may as well be talking about someone on another planet; I’m so devoid of feelings.’ Unfortunately, this therapist fails to see the dissociation in front of her and inaccurately reflects, ‘You seem to be doing remarkably well.’

Fortunately, Digene is swiftly re-allocated to a more experienced therapist, Janet, who clearly attunes to Digene’s level of trauma far better. We meet other therapists later on, although her relationship with Janet is particularly important and longest lasting, and obviously the one that contains the greatest psychological work and contributes to healing her severe attachment trauma. We learn about their long journey to make the unthinkable thinkable – not just the horrors of the terrorism, but the horrors of her repeated sexual and physical abuse.

This isn’t swift work, as we know. After nearly five years with Janet, in a chapter ‘Facing Reality’ Digene notes ‘I understand I need to talk and feel in order to heal; I just can’t seem to tolerate the feelings’. This leads into a year of ‘exposure therapy’ where although ‘tedious, excruciatingly painful and exhausting’, Digene concludes that ‘I truly believe exposure therapy is what saved me….providing me with a tool to ‘relanguage’ the experiences at my core and to connect the memories with the disassociated feelings. I’m now able to face them instead of running away from them or numbing myself.’

I wondered about Digene’s relationship with her body during all of this – her work with Janet seemed to be processing through talking rather than bodywork, although Janet did encourage Digene to write her feelings down when things became too intense. But while often dissociating from her sense of self and embodiment, Digene meanwhile maintains and builds upon a successful professional persona as a fashion model – her functioning part gains contracts through her innate good looks, but also her confidence and some sense of ‘I am beautiful’. The irony is another part of her feels so deeply ‘I am not beautiful’ that it has, at times, become annhiliatory.

This tension between liking/not liking her body and her struggle to integrate the past and present manifests strikingly around the years of efforts Digene makes to replace a false tooth with an implant. Knocked out as a child by an abuser, she is determined to have the smile she (sometimes feels she) deserves, but the implant doesn’t take and she ends up having repeated painful, expensive and unsuccessful procedures. Getting there in the end ties up with her integration – as if the implanted tooth couldn’t settle until she got there.

Digene’s relationship with her body is attended to in a different way at the Miravel Resort in Arizona, where she signs up for five days of personal challenges – including leaping off a high platform and spending time with a much feared horse. Her brief but powerful retreat ends with a moving letter to her younger self, conveying the unconditional love, acceptance and self-compassion she so needed during her early years.

In the chapter ‘Hands On’, towards the end of the book, we learn about Digene’s year of massage therapy – all the successful psychological work she had made eventually allowed for her to open herself to touch -something she had struggled with over the years. ‘I wasn’t sure what it would feel like to allow someone to touch me or hug me and remain present with the feeling’. Unsurprisingly, one massage triggers flashbacks – ‘it’s like my body’s key unlocked the doors to stored memories at a cellular level, one after another.’ However, trust in the skilled massage therapist and a stock of new resources allow Digene to experience the flashback with greater ease.

The book is not just a courageous and inspiring memoir. The shorter second section explores the unhappy reality that childhood sexual abuse is far from unique to Digene. Just as Van Der Kolk flags this up as an issue of (US) national importance, so does Digene, and she shares suggestions to survivors and those supporting survivors around seeking support and healing. And as her memoir testifies, the journey can be long, arduous, and may involve different ways of working at different times as the healing unfolds. I imagine this book to a tremendous resource to clients and therapists alike.