Eliana Gil - Treatment of Adult Survivors of Childhood Abuse
If you think it happened, it probably did.
Many times clients are ambivalent about the therapeutic process. Why treat abuse? It’s so painful; I just have to block better. If you could block it better you wouldn’t be here in the first place. The primary reason to treat your abuse is because in addition to limiting and impairing your own life, if you don't deal with your abuse, you may very well repeat it with your own or other children.
At the same time that we begin to treat the trauma we need to help clients understand what happened to them psychologically when they were abused.
Their boundaries were violated.
It was confirmed to them that they were powerless
It created shame and guilt - they were a part of something ugly and it kept happening - maybe at some point they even allowed it or liked it. They made a pact with abuse in order to survive.
That last point is very powerful - whether they disassociated, started to manipulate the survivor, responded inappropriately to the abuse or found some other means to get through it - they now blame themselves for their survival instincts. The self-loathing is very intense.
If they did try to tell someone and they weren't believed, or if they were punished for attempting to tell the truth, they were further traumatized, and it was confirmed that they were worthless and dirty. Ever since then they have felt as if there is something inherently wrong with them - this belief isolates them. They can't allow anyone to get too close because they will discover what a worthless, evil person they are.
If you were abused - your true feelings and instincts were shut down.
2. The person is able to bear the feelings associated with traumatic memories.
4. The memory of the traumatic event is a coherent narrative, linked with feelings. If the memories are implicit, then it is necessary to build a narrative around what they suspect happened and link that narrative with the feelings.
6. The person's important relationships need to be re-established.
Clients come in hating the abuser but a lot of times they realize that they are much angrier with the parent who let them be abused by not noticing. Because as they come to see it - the abuser couldn't help himself - the enabling parent knew better and should have done something about it.
How do people initially survive abuse?
1. Splitting - black and white thinking - good father and bad father or complete disassociation - there is a lot of disassociation among abuse survivors
2. Denying
3. Addiction
4. Cutting
5. Workaholism
6. Depression, anxiety, & Personality Disorders (Dissociative and Borderline, in particular)
So how do we help bring those within manageable limits? Here is a four-step model:
CALM yourself
CHOOSE a new response if possible. Or if another person is present - you may want to remove yourself.
At some point, partners get confused with abusers. Partners can help survivors identify triggers to automatic responses and they can figure out together what the survivor needs from the partner -i.e. To be held, to be talked to, to be encouraged to express feelings, to be allowed to stay inside your body without minimizing your feelings or yourself for feeling them.
1. Breaking the silence - with another individual (not necessarily the abuser) or with your therapist
2. Stopping the minimization, believing that it happened and beginning to trust yourself in the process
3. Understanding that it wasn't your fault - beginning to forgive yourself - starting to nurture yourself and take care of the child within.
"Once we identify the ways we replicate past abuse, we can begin to reduce the mystery and power our impulses have to control us.”
