In the experience of many therapists who are now working with postabortion women, it has yet to be found that time alone will bring  real, lasting healing. The old adage "time heals all" becomes "time represses all." While a postabortion woman may have acquired enough coping skills in her life to be a well-functioning member of society, the potential for deterioration because of the repressed pain always remains. When a woman comes to a point in her life where she recognizes the need to deal with a past abortion, a skilled professional or a lay counselor can be of great help in leading her through the tasks of healing.

Working through the denial (re-experiencing the abortion)

The very first task of healing is for the woman to access the negative feelings that surrounded the abortion experience. Most women, even those currently experiencing a great deal of postabortion stress, have utilized repression for so long as a coping strategy that they have long forgotten the fear, anger, guilt and grief associated with the abortion. Until these powerful emotions are fresh in the woman's mind again, there is literally not much with which to work.

The simplest way to access the feelings is to provide a safe, supportive environment in which the woman can tell about her abortion experience. The more she is allowed to verbalize, the more she will remember. Since a woman will naturally feel resistant toward deliberately doing something that will make her feel badly, a sensitive counselor can help her re-experience the abortion with very gentle prompting ("What were you thinking as you drove to the abortion clinic?" "What did the operating room smell like?" "What did the machine sound like?")

Dealing with issues of guilt and forgiveness from God

The Christian woman is very likely to begin, at some point after her abortion, feeling like a second-class citizen in God's economy, even though she may know this to be incompatible with Scripture. She usually will either turn away from the church completely, or enter into an intense compensation mode, with the rationale that if she is only good long enough, if she can only prove herself, God will surely forgive her someday. Of course, this is not a conscious thought process on her part. During therapy, however, she might startle herself by realizing that she even had a specific number of years in mind for a period of penance. If feelings of closeness to the Lord were previously enjoyed before the abortion, no such feelings now exist, and she probably believes the relationship to be irreparable in view of her atrocious sin. How dare she presume to sit at His feet like an innocent child after what she has done? Working her way back into the periphery of His kingdom, in the lowest rank of privilege, may be the highest spiritual goal she can imagine.

Norma was married at age twenty-five. When she and her husband returned from their one-week honeymoon, she discovered that she was already seven weeks pregnant. In less than twenty-four hours, she, her husband and her doctor had calmly decided on and carried through with an abortion, because they felt it would be a most inopportune time to have a baby. Norma later would have liked to say that she had been bullied into the decision. But, in fact, the decision was made rationally, and in retrospect, she took full responsibility for the choice. This was hard for her to live with during the next ten years because she had been raised in a Christian home where there was a high regard for life, even though she was not a committed Christian at the time of her abortion. She worked night and day in her church for five years after recommitting her life to Christ, and still could not begin to consider the idea that she might already be forgiven for the abortion.

One night during a postabortion group therapy session, as Norma was struggling with the idea of God's forgiveness, the leader asked her to think about what she expected from her young son whenever he did something wrong. "I want him to see the wrong action through my eyes -- without denying that he did it or making lame excuses for why he did it," she replied, "and I want to know that he is really and truly sorry for what he did."

She was perplexed when the counselor asked if she ever remained cold and punishing toward her son once he had reached the point of true repentance. "Why on earth would I do that?" she asked. "He is my child -- I love him!" Then  she slowly began to realize that God, as her loving parent, had been patiently waiting five years for her to simply turn around and ACCEPT his forgiveness. She then wept tears of joyous healing.

The most essential task for the Christian postabortion woman, then, is to accept on an emotional level what she probably already knows on an intellectual level: that God's forgiveness is already complete and that she must reach out and take a firm grasp of that forgiveness.  It is extremely helpful to use the loving parent/repentant child analogy if a woman can relate to it. (If she never had a loving parent, this might be a difficult concept for her to grasp.)

The parable of the unmerciful servant in Matthew 18 is illustrative of the predicament of the postabortion woman seeking to work off her sin. The servant, rather than begging the master to forgive his debt outright, asked for time to pay back the debt, which was impossible because the debt equaled far more than the servant's entire lifelong earning potential! Likewise, the parable of the prodigal son in Luke 15 is poignantly like the Christian postabortion woman who has settled for being the least among her Father's servants because she cannot bear living away from His household completely. Such a woman needs to put herself at the end of the story, where the waiting father is so elated to have his broken child back that, despite the past sin, he welcomes his child with a great embrace and with tears of joyful reunion. The son expected minimal acceptance but received maximum (and unwarranted) forgiveness. There was no talk of punishment; the father only wanted his son to return home.

Many women, even though they come to understand the loving, forgiving nature of God, are seemingly unable to move through this important second task. To trust fully is a very frightening proposition for someone who has never learned how to trust. Additionally, some women may unconsciously choose not to accept God's forgiveness. Holding on to one's "defectiveness" can become a rationalization for failing to move forward as a new, whole, functioning, ministering person in Christ.

It is interesting that women who come into group therapy with no particular previous religious affiliation will often express, to varying degrees, an awareness of God. Sometimes, as they observe Christians in the group individually experiencing God's forgiveness, there arises a yearning for that same reconciliation with our Creator. A Christian  counselor needs to be preparing to explain, in the simplest terms, how to grasp hold of his forgiveness.

Anger and forgiveness toward herself and others involved in the abortion decision

Most women experiencing PAS have repressed (or "stuffed down") a tremendous amount of anger since the time of the abortion. At the same time, there is usually a serious resistance to getting in touch with this anger and identifying it for what it is. Sometimes, this is caused by a fear that the expressed rage will lead to a total loss of control. The Christian woman is often especially hampered in working through this task area because she has sat through a great many sermons in which she was exhorted to forgive others as she has been forgiven by Christ, and not to harbor resentment toward another human being.

The biblical command to forgive others as we have been forgiven demonstrates a deep and beautiful truth indeed. Unfortunately, until we can identify precisely what needs to be forgiven, it lays beneath the surface like a pool of toxic waste material, ever threatening to build up and poison our efforts to reach emotional wholeness. The postabortion woman must stop denying the pain and anger she once felt (and possibly still feels) before, during and after her abortion. Helping her to clarify her anger clears a path to true and final forgiveness.

Elisa's mother and father had coerced her into getting an abortion when she was only 15 years old. In the postabortion therapy group, she denied, sweetly, any traces of bitterness against her parents, even though they had refused to discuss the episode with her over the years. As an adult, she knew that what they had done to her was wrong, but she believed that, as a Christian, she had no grounds for harboring any resentment toward them.

She shocked herself when she was asked to write a pretend letter to her parents telling them how she felt about their part in the abortion decision. The rage she expressed in written form distressed her greatly because she honesty didn't know where it came from. As she began talking about the contents of the letter in the group one night, she slowly realized that the anger she unconsciously held against her parents all these years had created a tremendous barrier in her ability to trust them or to feel close to them. That night she made a conscious decision to stop blaming them for the abortion, and the path to true forgiveness was now wide open.

It is interesting that sometimes a postabortion woman who is extremely hard on herself can easily extend compassion toward other members of the therapy group. Pointing out the inconsistency between her behavior and her thinking, coupled with the understanding and compassion felt from the rest of the group, will often help a woman relinquish her entrenched self-recrimination.

Liza met her husband while he was still in the midst of divorce proceedings. She became pregnant but did not tell him for fear of putting too much pressure on him during a time in his life that was already too stressful. Because it was 1956, Liza performed an illegal abortion on herself by inserting a sharp instrument through her cervix. She almost bled to death before finally getting to a hospital, where a physician angrily completed the botched abortion, verbally abusing her during the procedure for attempting such a stupid thing. Being a staunch Catholic, Liza was deeply ashamed of what she had done, and never told another human being about it until she entered a postabortion therapy group 31 years later.

She put off telling her story to the group as long as possible, and when she finally did start taking, she just could not bring herself to tell the other members of the group how she had actually tried to abort the child herself. After much gentle urging from the counselor, she finally blurted out her confession and put her hands over her face, waiting for the condemnation she knew would come. To her great surprise, the other women silently wept in sorrow for the turmoil she must have felt to be driven to such a desperate act, and for the burden she had carried alone for so many years. For Liza, the fact that these women were readily able to love her, no matter what she had done in the past, was a major turning point in her being able to forgive herself.

Grieving the loss of the aborted child

Many women experiencing PAS have never recognized the need to grieve the loss of their aborted baby. Hindering them in this important task of healing are: (1) the belief that, as the "executioner," it would now be hypocritical to mourn, (2) the fact that she has no memories of a whole child to facilitate a healthy grieving process, and (3) societal denial of the need to grieve what was, after all, only a "lump of pregnancy tissue." It is crucial for a postabortion woman to come to a point of understanding that she aborted a real human baby. Unlike the mother who has lost a 2-year-old, the postabortion woman has no memories upon which to draw. And since a healthy grieving process requires those warm memories, it is often necessary to help a woman "recreate" her baby by pretending she knows his or her physical characteristics in order to get a mental and emotional picture of the child firmly fixed in her mind. Naming the child also seems to be an important task because it gives her child individuality.

With a portrait now indelibly etched on her heart, she can begin the difficult task of asking her child's forgiveness for the abortion. This can be a very frightening experience for the Christian woman who pictures her child now standing next to God, stretching an accusing finger down toward earth. This picture, of course, adds to her feelings of alienation from God. This woman must come to a realization that nobody in God's presence could reflect anything but His love, compassion and forgiveness. After an emotional and tender reconciliation with the child she never knew, after she feels that her child has already forgiven her, she will finally be in a position to say goodbye to her baby -- for now.

A wonderful technique to help her facilitate this step is to encourage her to write a pretend letter to her aborted child, pouring out her heart and explaining (but not excusing) the circumstances under which the abortion was obtained. She might tell the child how much he or she is missed, how sorry she is, how she longs to see him or her someday, and so forth. Here is an edited version of an actual letter:

"Dearest Baby: I don't know how to begin writing this letter to you. I hope it's okay to think of you as a girl, because I always believed in my heart you were. You know, I only had your two brothers after I was pregnant with you, and I always wanted a daughter. I would have named you Dawn, and when I picture you, I see you with blue eyes, just like mine... Baby Dawn, what can I say to tell you how sorry I am that I don't have you to hug or to dress or to put ribbons in your hair? I was so young and frightened when I found out you were growing inside of me. I allowed some foolish people to talk me into killing the only daughter I ever had, and I have to live with that for the rest of my life... I'm so happy you're with Jesus now. For a long time now Heaven has seemed like a really scary place to me because I was afraid of seeing you again, but lately I've begun to understand that you understand and have forgiven me. I can't wait to hold you one day.
Goodbye, my precious daughter..."

It should be stressed, at this point, that the women working through this postabortion healing task must have a clear understanding that they are not, in actuality, contacting their children in any way. Rather, this is an exercise in the imagination for the purpose of gaining a clear understanding of where their children are, and what their future relationship will be one day when they are reunited.

Having successfully worked through these major task areas, will the postabortion woman ever feel pain over her past abortion again? Most likely. It is unrealistic to expect that someone who has grieved deeply will never come up against painful reminders of her loss. The goal, rather, is that she will become a whole, functioning person who is able to cope with those ongoing reminders as they arise, rather than feeling overwhelmed by them.

How can a postabortion woman know that she has truly experienced healing? She can be confident that healing has occurred when she is able to accept responsibility for her part of the abortion decision; she can speak openly about her abortion (not in a compulsive way) when it is appropriate to do so; she has accepted God's total and unconditional forgiveness; she has forgiven herself and will allow herself to lead a fulfilling life, despite her past sinful choices; she has extended forgiveness and understanding to others involved in the decision; and she feels reconciled to her aborted child, eagerly looking forward to someday being reunited with him or her.