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EXHIBIT "A" Case 9:09-cv-80469-KAM Document 34-1 Entered on FLSD Docket 06/08/2009 Page 1 of 5 June 4, 2009 The Psychological Trauma Center a division of Preventive Psychiatry Associates Medical Group, Inc. Medical Director: G ilbe rt W. Kliman, M. D. 2 105 Divisadcro St.. San Francisco. CJ\ 94115 Phone(415)292-7119 Fax (415) 749-2802 w1rn· experrch1/dpsvchiatrv.com Forensic Child Psychiatric £val11alions, Life Care Plans & Teslimony DECLARATION OF GILBERT KLIMAN, M. D. RE: EXPECTATION OF HARM FROM DISCLOSING THE PLAINTIFFS' IDENTITIES IN DOES V JEFFREY EPSTEIN 1. I, Gilbert W. Kliman, M.D., of2105 Divisadero Street, San Francisco, California, CA. Physicians License 055912, declare the following under penalty of perjury: 2. I have been retained by plaintiffs' law firm, Mermelstein & Horowitz, to give expert testimony. If called as a witness, I would testify truthfully and competently concerning my psychiatric findings about each of the plaintiffs' alleged experiences of sexual abuse, and the enduring effects that I find each of the young women have suffered as a direct result of the sexual acts perpetrated by the defendant. 3. I have been asked to respond to the Defense motion, which requests that some of the plaintiffs, who are now adults, should be publicly named. It is my opinion that involuntary public disclosure will result in the plaintiffs experiencing revictimization, albeit by a justice system that is designed to protect them. If their identities are released, the victims will be at-risk of having their personal lives scrutinized by friends, extended family, spouses, children, fellow students, employers and fellow employees, the media and general public. This type of exposure humiliates many victims and represents another betrayal of trust. Public exposure places the plaintiffs at further risk of stigmatization, shame and retraumatization. 4. Due to traumatization the plaintiffs are arrested in their development, and even those who are now legally adults are arrested in part to adolescent aspects of psychology. 5. The plaintiffs do not hold their heads high with pride for having been sexually controlled by Mr. Epstein. They hold their heads low with shame. The internal life of a typical adolescent, into late adolescence and early adult years in the best of circumstances, usually involves generous proportions of self-consciousness, shame, self- absorption and self-doubt and self-blame about sexual acts. Case 9:09-cv-80469-KAM Document 34-1 Entered on FLSD Docket 06/08/2009 Page 2 of 5 6. Clinically harmful levels of shame, self-consciousness, self-doubt and self-blame are even more prominent among victims of molestations than among the general population. 7. Molested teenagers are particularly vulnerable to wrongful manipulations and special clinical harms from the experiences of shame and humiliation. In fact, shame and efforts to cope with it played an underlying role in the harm to each plaintiff. Each was lured into Mr. Epstein's sexual lair with the promise of overcoming bodily and sexual shame by earning money and bettering their lot in life. The defendant capitalized on their sexual naivete, insecurities and effort to better themselves, and he worked hard to overcome their shame at his enlistment of them in his selfish gratifications. 8. The defendant who wishes to make their identities public is one whom the criminal justice system has already determined is a person who has already committed a crime of child molestation. That surely means he has already exploited and manipulated the girls' state of adolescent sexuality, including their embarrassment, awkwardness and bodily self-consciousness. He perverted their nascent and developing moral structures by posing as a generous, avuncular mentor who could coach them about their bodies, sex and love. The exploitation of adolescent bodies, sex and love is - from a psychoanalytic point of view- an influence on the developing moral conscience of the children, as well as on their sexual urges. Now the ravaging of their internal and private moral conscience is intended by the perpetrator to be made a public ravaging. 9. Among sexual trauma victims, the insidious and destructive persistence of shame, humiliation and associated self-blame is well-documented (Finkelhor and Brown, 1985). Stigmatization, as experienced by a sexual trauma victim, has especially painful and pathologic consequences. Shame lingers and becomes integrated within the adolescent victim's malleable emerging identity, character structure and self image. Moral clarity is distorted. Perceptions of self-blame and guilt are magnified. The impact of shame lends to cultivating a self image of being "spoiled goods." 10. Stigmatization following sexual trauma results in long-term risks that can negatively shape multiple facets of adult development: sexual, emotional, interpersonal and vocational. Stigmatization, which is generally to be avoided among psychiatric patients, increases risks among those - as in our plaintiffs as a group - who experience clinical depression and self-destructive behaviors: drug use, criminal activity, even prostitution. Stigmatization following abuse is associated with delinquency due to increased anger and affiliation with deviant peers (Feiring et al., 2007). 11. Shame and guilt are important dimensions of both complex and single event, posttraumatic stress disorder (PTSD). Symptoms of shame are associated with feelings of helplessness and powerlessness, which each of the plaintiffs endorsed experiencing in relation to Mr. Epstein. 2 Case 9:09-cv-80469-KAM Document 34-1 Entered on FLSD Docket 06/08/2009 Page 3 of 5 12. The DSM-IV-TR recognizes both powerlessness and helplessness as requisite parts of the traumatic experience in Criterion A for the diagnosis of posttraumatic stress disorder trauma (Martin Seligman, recent Past President of the American Psychological Association, coined relevant terms of "learned helplessness and "Loss of Personal Locus of Control." See Seligman, M.P. l 97 5: Helplessness, Depression, Development and Death. W. H. Freeman, San Francisco). The teenaged girls suffered the loss of personal locus of control to a much more experienced, sexually aggressive, powerful and dominant, manipulative perpetrator. 13. Releasing names of the plaintiffs to the public will reenact experiences of powerlessness and helplessness in the face of a boundary violation. Repetition and reenactment represent central features of Criterion B in the DSM-IV -TR diagnosis of posttraumatic stress disorder trauma. In effect, release of their identity and public intrusion into their personal life represents a reenactment of the shame of sexual traumatization. Repetition and reenactment are central pathologies that afflict sexual trauma survivors. 14. Victims of sexual abuse often rely upon some form of dissociation, splitting or denial, as a defensive means to manage overwhelming affects associated with the sexual trauma. Each of the plaintiff girls has employed some variation of this defense, both during the massages and then subsequently following disclosure of the abuse. Primitive, maladaptive responses of this nature will become additionally reinforced as a result of public disclosure. 15. Another aspect of the plaintiffs' experience, which is recognized by DSM-IV -TR, is that the trauma was associated with human design factors (such as cruel intention to do harm, rape, torture). Trauma of this origin has a tendency to produce more "severe or long lasting" posttraumatic stress disorder than natural events (DSM IV TR p. 464). A policy of deliberate revelation of the names of the victims would reinforce the sense of design, pattern and policy of human intentions. 16. Negative expectations about significant activities are noted in DSM-I