"It is estimated that there are
60 million survivors of childhood sexual abuse in America today." As
quoted from Forward, 1993.
On this track, we will discuss the
three core defenses of memory repression, dissociation, and denial, commonly used
by children who are living with their secret of sexual abuse. At the end of this
track, we will look at the various ways the Timeline Technique can be used.
Three Core Defenses
#1 - Memory Repression
As
you are aware, the first core defense memory repression, occurs when extremely
strong feelings of shame and horror are experienced during an encounter of sexual
abuse. Douglas, age 12, was sexual abused by his Uncle George at age 5. He had
no memory of the abuse when he was referred by Child Protective Services for acting
out, fighting and being repeatedly expelled. Douglas stated, "I often feel
angry at my friends and teachers. I am always put into detention at school."
It
might be noted according to MSNBC News, the suicide rate among sexually abused
boys was 1½ to 14 times higher than girls in a similar age group. Reports
of multiple substances abuse among sixth-grade boys who were molested were 12
to 40 times greater than their peers in the same age group."
Later
as Douglas recalled his abuse, two major factors seem to have contributed to his memory repression.
Two Contributing Factors to Memory Repression
a. The first was his age at the time of the abuse. Douglas
was five. As you know, studies indicate the younger the child, the more likely
they are to experience complete memory loss of the abuse. An older child, beyond
age 7, seems to use a combination of core defenses, in addition to memory repression
b. The
second contributing factor to memory repression was the level of the violence that Douglas was subjected to. Douglas had been beaten, tortured and violently
sexually penetrated. He subconsciously used memory repression as a means of primary
defense and survival. I find the Timeline Techniques described at the end of this
track to be beneficial.
#2 - Dissociation
The second core defense used by survivors
of childhood sexual abuse is dissociation. For Douglas, dissociation meant that,
once he remembered being sexually abused, he felt emotionally disconnected from
the experience. Douglas' dissociation included the memories of his trauma, but
not the pain of the experience. Generally, I have found that there are three different
forms of dissociation.
Three Forms of Dissociation
a. The first form of dissociation would
be to for the person to "go numb." As you are aware, when the abuse
is recalled, emotions are numb and it is as though the connection to the client's
self has been severed. Douglas often talked of his abuse as though it happened
to someone else. He stated in a flat expressionless tone, "I remember my
uncle hitting him. He wouldn't stop." Notice Douglas used the word "him",
rather than "me".
b. The second form of dissociation
is "switching off." For survival, Angie, age 15, who was sexually abused
when she was 7, would "switch off" the feelings and body sensations
experienced during the sexual abuse. It was a simple but effective defense. If
she did not feel the pain, then she felt "safe" no matter what was happening
to her body. This seems to be most common for very young children who need to
feel "safe"
The difference between "going
numb" and "switching off" is that when Douglas went numb he
would refer to his abuse as though it happened to someone else. In switching off,
Angie shut down her body and felt nothing.
c. The third form
of dissociation is referred to as "splitting off" and occurs when a
child being abused has the feeling of leaving their body. It is a physical sensation
of disconnecting and moving away from their body entirely, so as not to feel their
overwhelming terror. Josie, age 16, stated, "It seemed like I was a ghost
out of my body watching my Dad doing those horrible things to me."
Think
about your sexually abused client? Which form or forms of dissociation does he
or she use? Going numb? Switching off? Splitting off?
#3 - Denial
In
addition to memory repression and disassociation, the third core defense is
denial. Renee, age 14 used denial by minimizing or downplaying the extent of the
abuse and the impact it had on her life. Renee had been abused starting at the
age of 7, for a semester, by her gymnastics coach, Mr. Rogan.
Renee had clear memories
of the abuse and could relate in detail what happened to her, but denied that
it had any impact on her. Renee stated, "It only happened a few times, so
I thought that it was no big deal. Besides it didn't hurt and felt good, even
though I was ashamed about it. I would hear my friends talking about sex and boys
and realize they were talking about things I had already experienced. I began
to feel really angry when I thought about my coach. How could he do that to me?"
The
three core defenses of memory loss, dissociation, and denial often work to support
and facilitate one another. These three core defenses ensure the emotional, and
even physical, survival of the sexually abused child. Douglas', Angie's and Renee's
powerful feelings during the abuse were contained utilizing some of these defenses.
Timeline Technique
To assist Douglas, Angie and Renee in their efforts to bring
down their core defenses resulting from sexual abuse, I found the Timeline
Exercise to be beneficial. Here is how it worked with Douglas.
I
provided Douglas with a horizontal sheet of paper that had a line drawn across
it. He included the names of family members and significant people with which
he interacted and the dates they either; arrived, moved out, interacted with family,
visited or had any impact on Douglas. We continued to use the timeline during
a number of sessions, as I had Douglas discuss: Who on the timeline did he think
of when he was asked about family? Who did he have the least or vaguest memories
of? Who was he most comfortable with and least comfortable with? For example Douglas's
Uncle George was placed on the timeline at age five.
Three Key Words Technique
Next,
I employed the three key words technique. I asked Douglas to list three words
next to each person on his time line that described that person. The three words
that Douglas listed after Uncle George's name were big, fear, and hate. I then
asked Douglas, "Can you tell me more about these three words? What does the
word "big" mean to you regarding your Uncle George?" It seemed
to be the trigger that marked the beginning of the end of Douglas's memory repression.
A key focus, of course, to my responses was to reinforce Douglas for his courage
regarding facing his secret of sexual abuse.
Douglas and I
continued this exercise in several subsequent sessions by reviewing other observations
about the word descriptions and the people who had the most impact on Douglas.
This exercise helped Douglas gain a clearer picture
of his family, his past and potential impact, jogging bits of memory as the information
gained from the timeline was discussed. Think about your Douglas and his or her sexual abuse secrets. Would he or she benefit from utilizing the Timeline Exercise?
On this track, we discussed the three core defenses commonly used by survivors of childhood
sexual abuse of memory repression, dissociation and denial: as well as the role
a Timeline Exercise places in assisting your client to uncover their sexual abuse
secrets.
On the next track we will look at the secondary consequences
of narrow range of emotions, emotional flooding, emotional numbing and shortened
attention span.
Peer-Reviewed Journal Article References:
Assink, M., van der Put, C. E., Meeuwsen, M. W. C. M., de Jong, N. M., Oort, F. J., Stams, G. J. J. M., & Hoeve, M. (2019). Risk factors for child sexual abuse victimization: A meta-analytic review. Psychological Bulletin, 145(5), 459–489.
Betsch, T., Wünsche, K., Großkopf, A., Schröder, K., & Stenmans, R. (2018). Sonification and visualization of predecisional information search: Identifying toolboxes in children. Developmental Psychology, 54(3), 474–481.
Böge, K., Mouthaan, J., & Krause-Utz, A. (2020). Effects of dialogical mindfulness on psychopathology: A pilot study’s results from a seven-day psychosynthesis course about the inner child. The Humanistic Psychologist, 48(1), 84–99.
Golding, J. M., Sanchez, R. P., & Sego, S. A. (1999). Brief research report: Age factors affecting the believability of repressed memories of child sexual assault. Law and Human Behavior, 23(2), 257–268.
Kessler, B. L., & Bieschke, K. J. (1999). A retrospective analysis of shame, dissociation, and adult victimization in survivors of childhood sexual abuse. Journal of Counseling Psychology, 46(3), 335–341.
McNally, R. J., Perlman, C. A., Ristuccia, C. S., & Clancy, S. A. (2006). Clinical characteristics of adults reporting repressed, recovered, or continuous memories of childhood sexual abuse. Journal of Consulting and Clinical Psychology, 74(2), 237–242.
Online Continuing Education QUESTION
1
What are three forms of dissociation a sexually abused child may experience?
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