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Thursday, April 25, 2019  


Miss America. The epitome of perfection, idealism, grace, and beauty. Every man’s dream of the perfect girl. Miss America 1958 seemed like no exception. Yet, in 1991 that Miss America changed the course of history. Marilyn Van Derber went public about being an incest survivor at the hands of her Denver millionaire father. The public was shocked. A topic like incest was only thought of as taking place in "other" families … certainly not wealthy, influential, public figure families like the Van Derber’s. Yet, the truth about childhood sexual abuse is that it crosses all ethnic backgrounds, socioeconomic lines, and cultures. Why did Miss America go public? Why would she take the chance of displaying her "shame" in the media? Why would she risk "tainting" the image of Miss America?

Because she wanted to help others.

In her new book, Miss America By Day, Lessons Learned from Ultimate Betrayals and Unconditional Love, Van Derber describes her life, both as a child and as a grown-up dealing with the aftermath of 13 years of sexual assaults. While the first half of the book is biographical, the second half is educational. She describes the ongoing physical battles she dealt with as a result of the abuse. Terrifying insomnia. Physical pain that went undiagnosed for years. Emotional trauma that oftentimes left her with paralysis. Fears of sleeping in any room without a lock on the door. Complicated behaviors, which might not make sense to most health care professionals – unless they were educated in the signs and symptoms frequently associated with abuse survivors.

One of her missions is to educate health care providers about these issues. Instead of thinking that a patient is just acting "crazy," a wise and sensitive health care professional can make all the difference for a survivor of abuse. By asking the right questions and being attuned to overreactions that seem too large for the situation, the caregiver may open doors to healing that the patient never anticipated. The road to recovery for abuse victims often comes years after the events themselves – many survivors may not show symptoms until their 40s or later. Typical symptoms might include sudden, unexplained weight gain or loss, extreme anger or depression without apparent cause, or dramatic change in personality, to name a few.

Van Derber explains, "My entire medical history can be traced back to incest. What our lips can’t say, our bodies will tell us." The book describes many ways that health care workers can give special support to victims. Understanding the overwhelming issue of shame and embarrassment that survivors contend with every day can provide a framework for health professionals to change their basic care. Simple things like keeping nursing and medical students from observing procedures like gynecological exams or giving birth can be huge steps to avoiding reactions of overwhelming panic. Opening the door to the possibility that abuse may have lead to physical symptoms, Van Derber stresses the importance that a standard question in any physical exam should be whether or not the patient has ever had an abusive experience. No one may have ever asked the question before and just asking it may open a door to recovery. Simply asking, "What can I do to make you more comfortable?" during procedures as simple as using a tongue depressor, (reminiscent of oral sex memories,) or reassuring the patient that only one person will be touching her and that safety will be assured at all times, may make the experience much more tolerable.

Van Derber’s other goal is to educate parents about how to keep their children safe from abusive situations. Her major motivation in writing the book came as a result of listening to survivor stories, hearing these words, literally thousands of times: "When I was 7 and my brother was 13…" Only the ages changed. The most frequently reported age when sexual abuse begins is between 5 and 6 years old. Fourteen year-olds comprise the largest number of sex offenders of any age group. With this in mind, parents must start talking to, and teaching their children about this possibility at a very early age. Abuse is rarely carried on by some stranger. It happens most often in the home. "While it is difficult to control domineering fathers who incest their daughters, we can do our best to teach families about babysitters and older siblings," says Van Derber. "We must also educate that sexual interaction between siblings is not ‘normal experimentation.’ It doesn’t have to be rape or penetration to leave long-lasting scars. It isn’t what’s done to us rather; it’s how it makes us feel." Keeping the secret frequently leads to shame, guilt, and doubt and it’s those feelings that affect every aspect of a person’s life.

Van Derber has spent the last 12 years lecturing throughout the country about the effects of childhood sexual abuse. Now, at age 66 she wants to spend more time with her grandson, Max, and her husband Larry, who has been her Rock of Gibraltar throughout her lifetime ordeal. "I really need to go now. It’s time to do something else," she proclaims.

Fortunately, her memoirs will educate others for years to come. This book should be required reading for health care professionals in all fields. With one in three women and one in six men in the United States abused before the age of 18, the number of survivors seen in the health care system on any given day is astounding. Unfortunately, most will not identify themselves to you. Yet, with kindness and understanding, you may be able to offer them a lifeline they have never been offered before.

Van Derber’s book can be ordered at


by Mary Jo Fay

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