I am proud to share news of the publication of a lyric essay that I have co-authored with my colleague and friend Patricia Debney (also a survivor of child sexual abuse (CSA), also abused by her father – Patricia is a poet, memoirist, academic and activist). Our essay ‘Twenty-five soundings about child sexual abuse and the arts: considering the opera Festen’ is published in the British Medical Journal (Medical Humanities). Please note that in places the essay alludes to subjects that some readers may find distressing.

The idea for this lyric essay came to us when we went to see the new opera Festen (music by Mark-Anthony Turnage, libretto by Lee Hall) at the Royal Opera House in London, in February 2025. Turnage and Hall based their opera on the 1998 Dogme 95 film with the same title, directed by Thomas Vinterberg. In Festen, revelations of child sexual abuse are made by Christian and Helena at their father Helge Klingefeldt’s 60^th birthday party. The drama revolves around the reactions and interactions of party guests, hotel staff and various members of the family including the perpetrator Helge and his wife Else (mother to his children).

After the opera, Patricia and I couldn’t stop talking about it: how it made us feel, what it brought to mind, where it worked well, how it might work better, what seemed to be missing. Those chats led us into discussions about representations of CSA in the arts more generally, and so provided the basis for our lyric essay. Our piece looks at how CSA is presented in Festen and in other art works, and along the way we write about many aspects of being survivors and writers, and (in our different ways) activists.

I have never wanted to be defined by the events of my childhood (I was sexually abused by my father from the age of approximately 6 or 7 to the age of about 11) or by the life-altering and lifelong fallout from that abuse. But the further I move through life, the more fully I realise just how far those events (and the culture that allowed them) shaped the child I was, the adult I became, and the writer I am. One way or another, each of us grows from the stuff of our beginnings.

When my memoir The Missing List was published in 2018, there weren’t many writers publishing about child sexual abuse, or about surviving it. The MeToo movement, which had started in 2017, was just gathering momentum, and ‘rape culture’ – a phrased coined in the mid-1970s – was gaining popular usage alongside MeToo. But in 2018, the words child sexual abuse were still whispered in shame, and most of the shame was foisted onto survivors. CSA was thought (by the general population at least) to be rare, and to be perpetrated by monstrous strangers. 

Things have changed since then. Facts have come to light. Research has shown the horrifying extent of child sexual abuse in institutions and in families. Right now, every day brings new revelations about abuse and abusers in every corner of society, everywhere. It is impossible for any of us not to notice the press coverage all around, impossible not to be shocked by the suffering. But, as tends to happen with deeply-rooted taboos (and CSA is probably the most deeply-rooted of them all), the subject rises in public consciousness only to sink again. As T.S. Eliot wrote in ‘Burnt Norton’, the first of his Four Quartets: ‘human kind / Cannot bear very much reality.’

Yes, things continue to change – but they need to change more fundamentally, and much faster. This urgency is what Patricia and I had in mind as we were writing our lyric essay.

After The Missing List was published, I thought I might not write much more on the subject. But the processing of trauma continues, and my evolution and growth continue too. I become stronger and more determined. Amongst and around all the other writing I’ve been doing since 2018, I have returned in various ways to the subject of CSA. In 2020, I wrote a list-essay for a/b: AUTO-BIOGRAPHY STUDIES entitled ‘Listing the Unthinkable’ – if you’d like to read it, drop me a line at clarepbest@me.com and I’ll send you the pdf. I also wrote a number of posts for the BMJ Medical Humanities Blog, including this one. Then in 2025 I wrote a chapter for a book entitled Shaped by Our Own Words: love and hate letters to writing – which is due out from the University of California Santa Barbara later in 2026. My chapter traces how my writing of The Missing List ran in parallel with ten years of pyschotherapy, and how my life opened up as a result of those linked processes.

Of everything that I’ve written on the subject of CSA since The Missing List, this lyric essay ‘Twenty-five soundings about child sexual abuse and the arts: considering the opera Festen’ feels important in new ways. First, Patricia and I collaborated on it completely – every step of the way – and I believe the sum of our two voices is transformed into a powerful chorus. Second, ours is the first lyric essay that the BMJ Medical Humanities has published; we are excited to be part of a movement in the wider medical community to engage more and more fully with writers who bring their art, as well as their lived experience and their book learning, to the page. The process of working with Patricia and with BMJ Medical Humanities editor, Sabina Dosani, has been deeply worthwhile and fulfilling.

We are grateful to the BMJ for their kind permission to share our work with you. 

You can read more about Patricia Debney and her writing and activism here.

If you or your institution has a subscription to the BMJ Medical Humanities, you can of course access our essay in the online journal.