Working with adult survivors of childhood sexual, emotional and physical abuse and incest
Working for the last 5 years with adult survivors of incest and childhood sexual, emotional and physical abuse, has developed my specialist interest in this area of work. Trauma in childhood can have a huge impact both short and long-term. This impact will often be present in adulthood and may lead to depression, anxiety, loss of identity, addiction and difficulty in maintaining relationships. These traumatic experiences can be very difficult to talk about and can cause a whole array of overwhelming thoughts and feelings. Trauma therapy aims to build a safe and trusting relationship with the therapist before exploring and processing the past, which is essential in creating the right environment for you to begin the trauma therapy journey.
Like adult victims of sexual abuse, children experience significant psychological and emotional distress. Unlike adults, however, they are traumatised during the most critical period of their lives:
When assumptions about self, others and the world are being formed;
When their relations to their own internal states are being established; and
When coping and relationship skills are first acquired.
Therefore, the Post Traumatic Stress reactions impact upon the child’s subsequent psychological and social maturity and often leads to dysfunctional development. In other words, if untreated, the effects of sexual abuse in childhood usually have a much bigger impact, in contrast to trauma effects in adults who have a stable base development and maturity to draw on and for whom, with support, the trauma effects will become less over time.
Impacts of childhood sexual abuse are likely to occur in three stages.
- Initial reactions to victimisation:
- involving Post Traumatic Stress reactions
- alteration in normal childhood development
- painful affect
- cognitive (thought) distortions
- Accommodation to ongoing abuse:
- involving coping behaviours intended to increase safety and/or decrease pain during victimisation (i.e. memory suppression, denial, dissociation, accommodation syndrome; Stockholm syndrome).
- Long term elaboration & secondary accommodation reflecting:
- the impacts of initial reactions and abuse-related accommodations on the individual’s later relationships the survivor’s ongoing coping responses to abuse, (Cognitive distortions, denial, memory suppression, dissociation, altered emotionality, i avoidance, problems in relationships).
For adults abused in childhood, who received no counselling or support at the time, some of their initial reactions to the abuse may lessen over time but more typically such disturbances get worse over time. These are the impacts which need to be addressed in working with adult survivors of childhood sexual abuse.
The key objective of counselling with adult survivors of childhood sexual assault is to facilitate trauma resolution and foster healing and growth.
Normalisation of your reactions to the abuse experience and the effects this has had on your psychological functioning, both historically and currently, is a key factor. It’s important to point out that the coping strategies you may have developed helped you to survive at the time and adapt. In that way, these strategies served you well. However, these responses may have become maladaptive in adulthood and limit your ability to live a full life, limit your interpersonal relationships and your psychological functioning.
Education about the psychological effects of childhood sexual assault is also important. It helps de-stigmatise your own experiencing and also helps to normalise your responses. Information about the lasting effects of childhood sexual assault, the types of difficulties experienced and presenting symptoms survivors encounter and how to cope can help you better understand your own range of behaviour or responses.
Both normalisation and education are critical particularly at the beginning of the counselling process and can be seen as preparing you for the healing process. The healing process is not always easy and your memory of the abuse will not magically go away.
I can provide a safe environment and a structured process to help you acknowledge your memories and associated pain, assess the influence these have on your behaviour and begin to integrate them with your adult self. This integration will allow you to process the memories and pain so that they no longer control your behaviour and responses.
The early phase of therapy focuses on building trust between the counsellor and the survivor and preparing the survivor for the healing process. During this phase of therapy you will be encouraged to tell your story which allows me to assess which therapeutic techniques may be the most beneficial.
This can be very difficult and I aim to help and support you through this and go at your pace. You will not be forced to tell your story if you’re not ready or go into detail if you don’t want to.
The later phase of therapy includes re-processing the trauma. Simply stated, processing the trauma of childhood sexual assault involves:
- Acknowledging the fact of the abuse and its impacts.
- Experiencing and releasing some of the feelings associated with the trauma that typically has remained unexpressed.
- Exploring a range of feelings towards the abuser/s and non-protective parents, siblings or caretakers.
- Making cognitive reassessments of the abuse (i.e. why it happened, who was responsible etc).