“Leave your pain here and go out and do your magnificent things.”

If you had asked me—a psychiatrist—who was most likely to say this to a survivor of sexual abuse, I would have said one of my mental health colleagues. But these were the words of a judge. Specifically, Judge Rosemarie Aquilina, who used her courtroom to offer the time, space, and validating, supportive words to create a therapeutic place for the survivors testifying in Larry Nassar’s sentencing hearings. In fact, her court proceedings actually read like the stages of recovery we learn about in mental health training for working with survivors.

First, trauma-specific training teaches that recovery begins with the establishment of safety—of one’s body, emotions, and thinking, but also of one’s environment and relationships to others. We want to promote self-empowerment and a re-establishment of a sense of control, as trauma often stems from power inequality and a loss of control. For a survivor testifying in court, there is an even more pronounced loss of power, since the judge is typically seen as the most powerful person in the room. While survivors are often encouraged to testify, courtroom testimony—with its hostile cross examinations, public discussions of private events, and even lenient sentencing— has the potential to re-traumatize someone, particularly in a case of child sexual abuse. We only have to think back to Brock Turner’s sentence—just six months in prison— or Taylor Swift’s cross examination to understand how this re-traumatizing could occur.

Using another page right out of our textbook, Judge Aquilina took on the role of the therapist and “bore witness” to the survivor’s story. This is reminiscent of the second stage of recovery, known as remembrance and mourning. Survivors told their stories and she listened. She allowed them to share what they wanted, in their own words, and on their own time. She also validated their experiences and the strength it took to come forward. While a hostile response to a story can aggravate and prolong the impact of a trauma (imagine a judge asking: “Were you drinking at the time? “What were you wearing?”), a supportive one can mitigate it. Judge Aquilina somehow knew that, like when she told Rachel Denhollander, the first to come forward, “You started the tidal wave. You made all of this happen. You made all of these voices matter…You are the bravest person I have ever had in my courtroom.” And by doing this, she told other survivors of abuse listening from home: you deserve to be heard and supported. Somewhere, someone who was saying “me, too” alone finally felt she might be safe to speak out about the abuses she also suffered.

And that’s why the creation of this safe space by Judge Aquilina was so unique—and so important. Women who might have otherwise been afraid to speak changed their mind when they saw her in action. Knowing their stories would be treated with respect, I’m not surprising that more and more survivors opted to deliver impact statements. An original list of 88 women grew to 156. Recovery cannot occur in isolation. By supporting this choir of voices, Judge Aquilina allowed collective healing to begin.

Judge Aquilina also helped to normalize survivors’ responses to their experiences. Much like a (trained!) therapist, she translated self-blame into a realistic judgement of the events. She spoke of women being strong through suicidal thoughts, anxiety, self-harm behaviors, and depression, but she did not discount that they struggled or blame them for it. With her responses, she affirmed every survivor’s dignity and value instead of her shame. While she was no doubt protected in part by the fact that Nassar was already convicted, she still could restore power to the survivors and express an understanding of the injustice that occurred. She—again, like a therapist would—assumed a position of solidarity with them. Unfortunately, she shared another similarity with clinicians who work in trauma, in that she was suspected of crossing a line by some of her colleagues. But in my opinion, just because courtrooms are not typically run this way doesn’t mean they shouldn’t be.

The last stage of recovery is traditionally seen as reconnection, forming strong social bonds with others. This is an adaptive, healthy outcome where a newly formed “army of survivors” will help each other heal. (Studies have found that separating soldiers from their units increased the trauma of combat exposure and that community is protective against long-lasting symptoms of PTSD.) The community created by these stories extends far beyond the women involved. It has been said that if perpetrators cannot silence their victims, they try to make sure no one listens to them. Well, thanks to the 156 impact statements from these women—and Judge Aquilina’s handling of the case—now everyone is listening.

Jessica A. Gold, M.D. M.S. is chief psychiatry resident at Stanford University. Find her on Twitter @drjessigold.

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