On the last track we discussed the danger of external disconfirmation. The focus of this track was on the client insulation technique. The basis of this technique is to devise measures to render a client more immune to external degradation through cognitive promotion.
On this track we will discuss addressing feelings of disempowerment. Clearly, childhood sexual abuse contributes to low self esteem. As you know, between the ages of 8 and 12, children are building the personality traits they will call upon later on in life. Sexual abuse warps and interrupts this process.
We will address the idea of empowerment as the foundation for healing and how to build it: through building a sense of responsibility and accountability; through developing a client’s understanding of his power and its limitations; and through equipping the client with knowledge and empowering skills.
The Importance of Empowerment
As you know, when a child is sexually abused, he or she experiences a feeling of powerlessness. I believe that rebuilding a client’s feeling of empowerment is fundamental to the recovery process.
If a client does not resolve his feelings of powerlessness, two results can occur:
1. He or she will continue to see themself as a helpless victim with very few behavioral options.
2. He or she will try to regain power by controlling others through aggressive or abusive behaviors.
David exhibited the qualities of this last option known as identifying with the aggressor. David was referred to me after he was arrested for assault and battery. While in therapy, David revealed to me that his step-father, Jim, had sexually abused him as a child. This abuse consisted of Jim pushing David into walls. As you can see, David was reenacting his abuse. By adapting the tactics of his abuser, David was trying to overcome his feelings of powerlessness.
3 Ways to Build the Foundation of Empowerment
#1 - Rebuild Responsibility & Accountability
As you know, the first step in rebuilding a client’s sense of healthy or positive power is by rebuilding responsibility and accountability. David needed to recognize when choices are available, choose an alternative, and follow through on that alternative. To do this, I made sure that I involved David in all of the following: setting up the assessment appointment; developing the rules that we both would follow during treatment; planning his treatment; determining the extent and type of his participation in each session; and deciding when to leave therapy. I also encouraged David to make important decisions in his everyday life.
#2 - Help Clients Understand Power & its Limitations
The second step in rebuilding a client’s sense of healthy or positive power is by developing an understanding of power and its limitations. I felt David needed to recognize that the limitations on his power stemmed from the fact that when he was a child, he had power taken away from him. However, I reiterated to David that he could exercise power by choosing whether to develop his own ideas or to accept the ideas of others.
Each session, I discussed with David the various ways he controlled his environment since I last saw him. David stated, "This week, Kevin [the man he had assaulted] told me off and I didn’t hit him. I told him that I wanted to reconcile and we talked. And now we’re almost friends." By expressing and controlling his surroundings not through violent actions but through a verbal expression of emotions, David was already exhibiting his ability to regain power through healthy and positive means.
#3 - Equip the Client with Knowledge & Skills
In addition to rebuilding responsibility and understanding limitations of power, in addition to responsibility and accountability; and understanding of power and its limitations; the third step for David in recovering a sense power was by equipping himself with knowledge and skills. The use of knowledge and skills helped David recognize more options in situations and easing his feelings of helplessness. David realized that being powerful did not mean controlling others. To aid him in realizing this, I used the following "Self Evaluation" exercise beneficial.
Cognitive Behavior Therapy Technique: Self-Evaluation
As you know, clients like David are unaware of the effects his abuse had on his development. To help him, I used the CBT Strategy of "Self Evaluation" to analyze these effects and to initiate discussion. I asked David to make check marks next to the statements that best describe how he feels.
The statements that David thought best describe how he feels:
-- I feel different from other people because of the abuse.
-- I’m filled with anger.
-- I’m afraid a lot of the time.
-- My moods change all the time.
-- I can’t control much of anything now.
-- I can’t seem to get along with others.
The rest of the Self Evaluation Questions are found in the back of your manual that accompanies this Home Study Course.
A summary of his responses is as follows:
"I think the way my step-father treated me made me feel like I had to hurt others. I really want to change. I really want to have better friends and not feel like I have to control them with hurtful actions. I know now that the abuse happened because Jim made a bad decision and it didn’t happen because I was bad or deserved it."
Now that David could finally pinpoint the reasons he has been trying to violently control others, he is taking the initial steps towards addressing these impulses. David was starting to gain some insight into his feeling of helplessness stemming from his step-father’s behavior and not his own inherent weakness.
On this track, we discussed the idea of empowerment as the foundation for healing and how to build it: through building a sense of responsibility and accountability; through developing his understanding of his power and its limitations; and through equipping the client with knowledge and empowering skills.
On the next track we will discuss depression and anxiety co-occurring with low self esteem. We will examine primary depression and primary anxiety disorder.
Peer-Reviewed Journal Article References:
Boyd, J. E., Otilingam, P. G., & DeForge, B. R. (2014). Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: Psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatric Rehabilitation Journal, 37(1), 17–23.
Burke, E., Pyle, M., Machin, K., Varese, F., & Morrison, A. P. (2019). The effects of peer support on empowerment, self-efficacy, and internalized stigma: A narrative synthesis and meta-analysis. Stigma and Health, 4(3), 337–356.
Cattaneo, L. B., & Chapman, A. R. (2010). The process of empowerment: A model for use in research and practice. American Psychologist, 65(7), 646–659.
What are three ways that can rebuild a client’s sense of empowerment?
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