| On the previous track we discussed three types of dreams:
trauma dreams, freedom dreams, and resolution dreams.
On this
track, we will discuss the child's feelings of guilt and responsibility
and the child's beliefs regarding treatment of the child in the role of victim.
We will also look at the use of externalizing abusive messages.
As
you are aware, how a trauma is defined or interpreted by the child's parents and
therapist determines how the child views the event. If the child's feelings of
guilt and responsibility are dealt with effectively, the child ideally will feel
that his or her parents or therapists are letting them know "It wasn't your
fault."
Gloria, age 15, had been sexually abused by her
older brother, Tony beginning when she was 8. At the time, Tony was 16 and had
sexual contact with Gloria on a regular basis over four years. When Gloria was
12, she refused to go along with Tony's demands and he then proceeded to rape
her on two occasions. Tony's third attempted rape ended by Gloria stabbing him
with a pair of scissors.
When Gloria had turned to her parents
for help, she was asking for their support on many levels.
Gloria asked her parents 3 questions:
1."Do brothers do this to sisters?"
2. "Is this what I deserve?"
and
3. "Is this what I am?"
Gloria's mother dismissed the event, leading
Gloria thinking "No one can protect me, I am helpless. To be loved means
to be abused." Gloria's father reacted with anger and violence, making Gloria
believe "Adults only get angry when you ask for help," Thus, Gloria
learned, "If something bad happens, the appropriate response is a violent
one".
How Gloria's trauma was defined or interpreted
by her parents made the trauma one of the fundamental building blocks of her
personality. This was evidenced by Gloria's involvement at age 15 with an older
boy, John, age 19, who beat her and forced her to take Ecstasy, on several occasions.
Gloria's parents thought she was too young to be dating a boy John's age, so she
began seeing him secretly. She began to receive failing grades in most of her
classes. Gloria was fired from her babysitting job after she was caught sleeping
while the children were outside playing.
Now that we've seen
the beginnings of Gloria's beliefs that violence equals love; let's look at how
to reframe the guilt and responsibility that is the basis of her belief. As you
know, a child's beliefs surrounding the trauma are crucial to the child's construct
of self and view of reality.
Three Key Treatment Factors
At this point in Gloria's treatment I felt three
key factors were significant:
Factor # 1 - It is important to know what the sexual
trauma meant to the Gloria when it happened,
Factor # 2 - What it means to Gloria
now
Factor # 3 - How it will affect the Gloria's future personality development.
I found most probably like you, that the cognitive therapy
method of externalizing abusive messages is beneficial to helping sexual abused
clients to address and grow past their feelings of guilt and responsibility. With
Gloria externalizing helped her to understand the trauma in such a way that it
would no longer be incorporated into her construct of self. The key to accomplishing
this task... was to assist Gloria to externalize the trauma from her constructs of
her present and future self. A goal in my sessions was to clearly define the abuse
events as something wrong that was done to her, in short, it was not her fault.
I
showed her that her belief that "I am the sort of person that these things
happen to" had been internalized. I stated, "What do you think of the
idea that you are acting out of the belief that you are the sort of person that
abusive things happen to by allowing John to abuse you?"
Creating Affirmations
I
felt it beneficial for Gloria to create an affirmation to externalize the
internalized abusive messages. Instead of stating "I am the sort of person
that bad things happen to, I deserve this." Gloria created the affirmation
"I'm a good person that was in a bad situation. I did the best I could. This
affirmation helped Gloria in beginning to develop a positive construct of self.
Would the construction of an affirmation be beneficial to your Gloria during his
or her next session? Would replaying this track, track 2, be beneficial?
I
asked Gloria to list three harmful patterns that she experienced. I stated to
Gloria, "Sorting out what helped you, from what affected you negatively,
is part of moving from awareness to assessment to change." To facilitate
this process from awareness; to assessment; to change, I asked Gloria to answer
three statements.
3 Statements to Facilitate the Process from Awarness to Assessment to Change
--1. The first was to give an example of how
the patterns of abuse functioned in her family. Gloria stated, "We grew
up dreading my father's humiliating criticisms."
--2. Second,
after discussing family patterns, I asked Gloria to state specifically how
these patterns of abuse affected her attitudes and behaviors. Gloria stated,
"Now, when I'm afraid I may be wrong, I don't take the risk to say or do
anything for fear of being criticized."
--3. Thirdly, after
asking Gloria about a pattern of abuse and how this pattern affected her attitudes
and behaviors; I asked Gloria to state how the pattern of abuse blocks her
growth or harms her relationships with others.
Gloria stated, "I feel
this pattern of my father's humiliating criticisms is holding me back from standing
up to people when I need to be more forceful, like with my boyfriend John. I didn't
want to do the drugs and a lot of times I didn't want to have sex with him, but
his cuts and criticisms were so much like my father's voice, I just couldn't stand
up to him."
Would it be beneficial to your Gloria to discuss family patterns
of abuse, outside of sexual abuse; how these pattern effect his or her attitudes
or behaviors; and how these patterns sever to block her growth; to reinforce the
concept that "It's not his or her fault."
On this
track, we discussed how the child's feelings of guilt and responsibility and their
beliefs affect treatment of the child victim. We also looked at how the use of
externalizing abusive messages could benefit your client.
The
next track will discuss projection and introjection in the desexualization of
childhood sexual abuse, as well as the use of a "Positive Retrospection"
exercise.
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Duncan, K., PhD. (2004). Healing from the Trauma of Childhood Sexual Abuse. Westport, CT: The Journey for Women, Praeger.
Peer-Reviewed Journal Article References:
Ensink, K., Borelli, J. L., Normandin, L., Target, M., & Fonagy, P. (2020). Childhood sexual abuse and attachment insecurity: Associations with child psychological difficulties. American Journal of Orthopsychiatry, 90(1), 115–124.
Pulverman, C. S., Lorenz, T. A., & Meston, C. M. (2015). Linguistic changes in expressive writing predict psychological outcomes in women with history of childhood sexual abuse and adult sexual dysfunction. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 50–57.
Pulverman, C. S., & Meston, C. M. (2020). Sexual dysfunction in women with a history of childhood sexual abuse: The role of sexual shame. Psychological Trauma: Theory, Research, Practice, and Policy, 12(3), 291–299.
QUESTION
2
When clients have feelings of guilt and responsibility for the abuse,
what is one technique to externalize these internalized self-blaming attitudes?
To select and enter your answer go to .
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