Child Sexual Abuse: A Case Study and Treatment Process

Child Sexual Abuse: A Case Study and Treatment Process

This is a series of articles where I am working with someone who has gone through child sexual abuse. The intention is to give an inner view as to how I work with someone. Some content has been added or omitted so as to reflect what’s going on while working through abuse and trauma and its resolution and thereby describe the basic mechanisms of trauma.

Jane is 35 years old. She has a child from a previous relationship and is together with a new partner. She works part-time as an independent. She suffers migraines and ME (fatigue syndrome) with mild symptoms of fibromyalgia. She is cognitively aware that her symptoms relate to having been sexually abused as a teenager and she mentions that her relationship with her parents has always been difficult.

A session starts with finding a comfortable space in order to be able to relate to one another. I tend to ask some ongoing ‘daily living’ questions before inquiring into what the issues at hand are. In her case Jane is, to some extent, aware of what we need to focus on, which greatly assist the process. It often happens though that people come in just being aware of their symptoms, either physically or psychologically. At the beginning of the conversation it is important for me to get a sense of where we are, what the situation is, the level of memory access and our ability to work together. At this point I don’t emphasize any emotional release or engagement. I just want to get a general sense of the whole story.

To start the therapeutic process, I have her sitting comfortably in a chair and ask her to close her eyes (if I see people in person I have them supine on a treatment table). Jane gave her account that she’d been sexually abused at the age of 15 and 16 yrs old.

The first session:

Me: How do you feel?
Jane: I am fine.
Me: (her response is dissociative and doesn’t relate to my question). Yes, I know that you are fine but what do you feel in your body?
Jane: I am not so used to feeling in my body – I try avoiding feeling too much.
Me: (she is being honest now – a first step). OK I understand. Where would you say most of your energy is concentrated?
Jane: Probably in my head…. I feel that I am always thinking.
Me: OK so can you start with that. Can you feel the activity of thinking in the brain, in the head, without moving into the thoughts. Just the feeling of it (I am trying to get her in touch with her feeling sense).
Jane: It feels like there is a lot of pressure inside… and heat.
Me: Right. Now see if you can give attention to that sensation of heat and pressure, or activity, without wanting it to be different… and take notice of what you feel. (to feel the head is relatively safe as it relates to the conscious part of oneself – the body is more wired to contain the unconscious and generally has more emotional charge).
Jane: It’s getting a bit quieter in my head although I still feel some pressure.
Me: OK.. that’s OK. Now see if you can let your attention go also into the body without giving it too much focus. Just start with feeling your neck first…… then the shoulders and arms…… chest….. upper back…… belly…. pelvis and back…… and buttocks – legs. Are there some body-parts that you have more access to than others?
Jane: It is easier to feel my arms and legs then my trunk.
Me: OK… just register the difference… And which place in the body do you feel safe?
Jane: I would say my hands and neck. My neck feels very tense – like I am keeping a lot of control there.
Me: Right. OK. That’s OK…… Now, could you move your hands or make them into fists?…… and the same with your neck… can you contract the muscles and then relax them consciously…. Sense whether you get more presence in those parts when you do that.
Jane: Yes.. I do… It feels actually quite pleasant.
Me: Right. Tell me also: which parts of the body do you not have too much access to, or where you are feeling unsafe, unpleasant.
Jane: My chest feels really heavy – as if it has a heavy object pressing on it.
Me: OK, and how about your belly? (being sexually abused generally creates a disconnect with the area of the lower belly).
Jane: It feels very disorientating when I broach feeling my belly, like I start feeling nauseous if I stay there too long.
Remember we are into our session already for a good 20mins with Jane having her eyes closed. Using the felt sense and accessing the body, opens up access to the unconscious and deeper held emotions. Her discomfort indicates that she’s being pulled into the trauma-vortex.
Me: I want to see if you can allow a level of disorientation and nauseousness when you sense the belly without losing yourself in it. When you feel that it is getting too much I want you to move your attention to the hands and neck and get to feel a sense of control again. Can you do that?
Jane: I think so… I will try.
While she does this I monitor her visually and keep tuned into how she feels while doing this. Feeling nauseous and disorientated are physical symptoms of some underlying emotions. To get Jane to feel those symptoms helps her to regulate the high energy charge which is stored in the area.
Me: Tell me what is happening when you bring your attention into the belly?
Jane: It’s uncomfortable…. My head is spinning and my palms are becoming sweaty.
Me: OK….. Go a little slower into it. Feel the edges of the discomfort first… and see also if you can breathe into the area to give it space.
Jane: * Does deep-breathing into the area *
Me: Now gently move your attention to the neck and the hands…. Take a little break from being there. When you breathe while being in the belly….. when you deep-breathe it calms you down but I also notice that it disconnects you from what you feel there.
Jane: uhuh..
Me: I want you to see, when we go back to the area, if you can let your breathing go a little. Breathe somewhat irregularly into the area…. and when you feel that it activates you too much… when it starts to overwhelm you, you can breathe in a bit deeper again.
I have given her a few tools now to help regulate what she feels: her breathing, and moving her to a safe place in the body. I have noticed that she moves very quickly into a therapeutic process, so I have to be careful not to allow her to move too quickly into it without self-regulating what she feels (i.e. her nervous system). This tendency relates to the deeper layers of her character/personality (possible developmental issues) which we’ll outline as we go along.
I’ll let Jane work with this for some time while monitoring and slowing her down till she starts to move into emotion.
Me: How is it going Jane? (re-surfacing her a bit with my question).
Jane: When I do this now it stirs up a lot of emotion.
Me: OK. How is the nausea and disorientation? (diverting her attention and affirming the changes made).
Jane: I don’t really feel it now.
Me: OK. Just take note of that for a moment. Something is shifting already in the area…. How is the neck feeling?.
Jane: Better. A little less tension.
Me: Right. Notice also this new state of how you feel now compared to when we started.
Jane: Yes. I feel different. Calmer. And my belly feels a bit warmer.
Me: OK good. Now, without going to much into the emotional… what kind of emotion were you aware of in the belly? (I make sure to just talk about it rather than going into it, as I want to round up the session without activation).
Jane: Anger… lots of anger.
Me: Right… OK, anything else?
Jane: I guess also some sadness, but not as clear as the anger.
Me: OK good. Now, we don’t have time to go into it right now as the hour is coming to an end. Also, I think we have done quite a bit of work already today, and I want to leave you in a good space – feeling a bit more contained and balanced. We have made a good start with using the felt sense and regulating the high energy of the nervous system. Let’s continue in a week’s time if that sounds OK to you?

The next article will be a continuation of this one where we will outline further the progress of Jane’s journey in resolving child sexual abuse. We’ll move into the emotional charge; how it relates to her personal history of sexual abuse, and the physical symptoms.

In the previous article I described how I started working with Jane. This is how we continued. After a little chat when she arrives, and in order to ease any initial tension, I have her sitting comfortably again and we start the second session. In our little chat I also ask her what happened during the past week; if there have been any changes as to how she feels, how she relates to others and how she feels inside her own skin.

Our 2nd session:

Me: Start with where you are first Jane. Just follow the breathing…. Feel where your energy is and take your time, slowly getting in touch with the body and the feeling sense…… Once you feel a bit more settled, see if you can move your attention through the body, and notice which areas are more accessible than others……
Me: Last time we worked with the neck and the held tensions of bracing and control, possibly even where you keep a lot of resistance… and we achieved some movement, some tension release in that area. When that eased off, and the resistance that went along with it, we managed to come in contact with the belly area… just briefly touching upon it, as it was disorientating for you, and brought on some nausea. Remember also how we created safe activities in the body when feelings got too much – either by opening your eyes, breathing deeply or making fists. You can use these again as we go along this time, but see if you can go slowly in the areas which are difficult for you to access, or where you feel that there are lots of emotion being stirred up. If we go slowly into this, I will monitor the process and be with you all the time; we want to really hold the space for whatever arises, be it anger, sorrow, shame and guilt, or even physical pain so as to be able to process and digest whatever is still alive in your body and mind as emotional residue.
Me: How are you feeling right now?
Jane: I am feeling quite relaxed.
Me: OK good!…. where are you most when you feel yourself in the body?
Jane: I am still a bit in the head. It has been a busy day.. but I am slowly unwinding.
Me: OK.. that’s OK, just start there. Just feel what you feel.. the busyness…. leaving the thoughts to which your busyness relates, out of the picture for the moment… just observe the sensation…. and as I am talking to you, you will feel already that you are shifting, relaxing more, getting a little deeper in the body.
Me: Now in our introduction last time you mentioned that you were abused sexually in your teens. Was it a single incident or did it happen several times?
Jane: Twice. Once when I was 15 and once when I was 16.
Me: By the same person?
Jane: Yes.
Me: Could you tell me who this person was.
Jane: He was my uncle. They lived close by and would take care of me and my brother when my parents were away.
Me: OK. I notice that you are back in the head again……. See if you can re-connect with the body, without force or making too much effort. Certain things that we’ll address will naturally make you want to be in the head, as it feels safer – just be aware of that when it happens.
Me: Can you put your hands on the belly for me; just close your eyes, and slowly let your attention go into that area….. and tell me how it feels.
Jane: My hands on it feel comforting, safe. It feels a lot easier to be here compared to last time, although if I go deeper here it starts to feel unsettling.
Me: OK.. let your attention shift from the hands, where it feels comfortable, to the deeper level, where it starts to feel unsettling.
Jane: I am ok actually.. I am doing quite well.
Me: Right. Now I want to see if we can go back to what happened when you were 15 and 16. To begin with: which of these two incidents do you feel we have to address; to return to?
Jane: I think when I was 15.
Me: OK. Now as we go into it I want you to answer me as though you were back there again – speaking in the present tense. So, not… I was there etcetera, but… I am here…etcetera. This will help us to stay connected with what we are working with. It is a bit like transporting ourselves back in time as these emotions that occurred then are still alive, in the now. The difference will be that we are taking our present selves along to help process, and bring awareness to wherever it is needed.
Me: How is the belly feeling now? Jane: I am feeling a bit nervous now.
Me: OK, I understand. It will be alright…… Could you take us back to just before something happened when you are 15 and describe me where you are.
Jane: I am in my uncle and aunt’s garden.
Me: Is it a nice day?
Jane: Yes, it is.. it is sunny and I am wearing a summer dress and feeling the sun.
Me: OK. Just take that in.. the sensation of it. Are you alone in the garden?
Jane: Yes I am. My brother went with my parents so I am alone with my aunt and uncle.
Me: Right. What happens next?
Jane: My aunt comes around and says that she has to go to a meeting and will be back in two hours or so.
Me: How is that for you? What goes through you?
Jane: Not much. I am quite indifferent to it, although I prefer the company of my aunt over my uncle. But nothing weird has happened and so far, I am OK.
Me: OK, so if I am right, it is just you and your uncle now who are there?
Jane: Yes.
Me: What happens next?
Jane: After a while my uncle calls me in saying he prepared us something to drink.
Me: OK, tell me what you feel now in your body.
Jane: I am feeling disoriented and nervous when I bring up these memories.
Me: Uhuh, now, also notice how your breathing has changed and your body-temperature… and again, take some time to feel all this – both the body-sensations of heat and the breathing and the nervousness and disorientation. Stay with it for a while without losing yourself in it or giving in to it……. tell me what’s happening in you?
Jane: When you bring my attention back to the body it helps to stabilize me.. it makes me a little calmer, although I still feel there is a big storm under the calm.
Me: Yes, that’s right… we’ll get to that. We just want to make sure that you are regulating… that you are digesting whatever comes up so that you have enough space, enough capacity to deal with what comes up next, and don’t get overwhelmed and more traumatized. So we are going along slowly but at the same time, emotionally, we’ll be covering a lot of ground….. How do you feel now, are you ready to continue?
Jane: I think I am OK, yes.
Me: Can you tell me where you are now… what’s going on?
Jane: I am with my uncle now. We are sitting on the couch and he is sitting very close to me. I am feeling really uncomfortable with him so close but am afraid to say or do something.
Me: OK.
Jane: Also, it really confuses me. He is not supposed to be acting like this.
Me: Right. Again come back to the body while you are feeling those feelings – the confusion, being uncomfortable. What’s happening in the body?
Jane: I am getting a terrible headache and I feel this part of my body is contracting (pointing at the liver).
Me: Right, I also notice that you’re getting quite worked-up as we go into this?
Jane: Yes, it makes me really angry – he doesn’t have any right to do that to me, to come onto me like that. I am only 15.
Me: OK Jane, I hear what you are saying, but I want you to really stay with the body sensations, if you can. I want you to feel the anger; allow it… keep the space for it without losing yourself in it; without drowning in it… and use the body-sensations… the feelings in the liver and the head. Just to stay with it….. and me talking about it… bringing you back to here and now helps you to ground that emotion, to take the sharp, overwhelming edge, off it. Also, the liver is a place where anger and resentment settles, when there are residual issues left unresolved, so it is interesting that these sensations show up now in these places.
Me: How are you doing now Jane?
Jane: My head is still pounding but the tension around my liver has subsided.
Me: OK, stay a bit more with the head without focusing on it. Just bring your attention there lightly. Tell me also, how is the anger?
Jane: It has become a lot less, but still I am thinking he shouldn’t have done it.
Me: Right, I am with you there, he shouldn’t have…. but I want you to see if you can relax a little bit as we explore, even if it is just for a moment in this session. If you can reduce some of the resistance about what happened to you. The fact is it happened. I am telling you this because if you keep that blame alive; if you keep repeating to yourself that the anger you feel is because of what happened to you; because what your uncle did to you; you will just build up the anger again, and with it the headaches and most likely the other physical symptoms. I am not saying it is right or wrong… what happened to you. I am saying that what is important for me, for us… is to resolve this trauma, this emotional residue that is in your system; this is what gives rise to your symptoms. So I want you to see, cognitively, that you keep your anger alive by relating it to what happened to you; the memories of it, and the person involved in it, your uncle – and it is very likely to involve a certain sense of blame. You have had no choice but to escape into blame. It is your survival mechanism to deal with overwhelming emotions.
Me: Are you still with me Jane?
Jane: Yes. It feels right what you are saying. I never thought about it in that way.
Me: Right… just let it sink in….. Now, we have talked about it at some length, and the understanding of it is helping to diffuse some of the feelings and emotions already. Can you see if you can tune into feeling that blame; if it is, in fact, still there?
Jane: I can still feel it a bit, but it is now much more connected or fused with my anger… but even that is a lot less now… and my headache is much better.
Me: Right… Good. Allow a little more time to pass, till you feel you have moved through it.
Jane: OK
Me: Now, as we go along these same feelings will most likely come up again. A lot of your anger and resistances are still very much connected to the whole experience… but we have outlined so far, some of the mechanisms by which trauma is kept alive in your system, and you have experienced it on a felt sense level. It will be easier now to apply your mind to it; to hold the space for whatever comes up. And you can do this also at home, or when things come to the surface for you. It is very likely that other feelings will come up as well as we progress that are connected to what we have been talking about.
Me: How are you Jane?
Jane: I am feeling more relaxed. My hands are tingling. My head is kind of empty. I feel that it is a lot to take in, even though we haven’t gone that much further into what happened to me.
Me: Well on an emotional level we have gone already quite a way into the whole experience. Like I said, more will come up for sure, but for now, as you are in a good space, I want to finish this session and let the work go on by itself without us digging any deeper. Some feelings that we have addressed now will arise again. See if you can sit with them as we did now or, if it takes too much out of you… if you feel you are getting too focused on it.. just let them be, for what they are, and tell yourself that you will work with it in our next session. You will see that what we have worked with today will continue on a deeper level and won’t really need your conscious attention all the time. So just be at ease with the mood swings that may come about.. they will pass and you will be in a different space when we next meet .

I am seeing Jane for the third time. After a few sessions there is more trust between Jane and I (the client and therapist) and it will be a lot easier to get started and pick up where we left off last time. I still check in with her about what’s happened during the week since I have last seen her; if there have been any changes, etcetera.

This is our 3rd session. In the last week she’d been feeling lighter in her body with fewer headaches and joint-pains. She did have some flashbacks to what happened to her, but there seems to be more of a sense of objectivity to it, and she mentioned having tried to work with it, as we did in our session, whenever she could.

Me: How do you feel Jane?
Jane: I am in a good space for now. I do think we have a lot to work with still but am less dual mind about it – like wanting to run and at the same time knowing something needs to be done.
Me: OK, sounds good to me. Let’s continue, if we can, from where we have left off last time after we settle you in. As before just close your eyes and tune into the body. See where your energy is – right here and now. Mostly likely it will be a bit in the head if you have been busy doing things. Start there… with the sensation of it, without associating it with the things that you have been doing today.
Jane: I am OK now actually. I have had a few days off and haven’t done too much.
Me: Right. Good. So last time we worked with anger that came up and how it related to some of your physical symptoms, your headaches, pain in the liver area and possibly also connected to pains in the joints. How is that level of anger for you right now?
Jane: It is a lot less. It has been coming up now and then but I’m looking at it in a different way, from a different perspective, and taking out any blame that has been connected to it, has really helped me to let go of it. I have been having more sad feelings in the last few days and also feelings of shame. Maybe we can work with that a little more this time.
Me: Right. Now I want you to see if you can let yourself go back again in time to where we were last time….. so….. you are alone with your uncle, sitting in the living room and he is coming onto you….. He is sitting very close to you and it is making you uncomfortable. You will likely feel all of that again as we are there now… but less… we have worked with this last time so there is less resistance, less overwhelming. Or possibly you are quite OK to stay with it as it is now..?
Jane: I am OK yes. This part is more just a memory now without the strong infusion of emotion attached to it.
Me: OK good. I would like to go a little further then, if that’s OK with you. Tell me what is happening next?
Jane: He is starting to touch me and kiss me.
Me: OK, how do you feel now Jane… I mean in the body – here and now.
Jane: I don’t know. As I talk about it now it seems like it is not really happening to me but to someone else.
Me: OK, and how does that feel in the body?
Jane: I am not really in the body. I am more in my head… or not even there…
Me: Right. Now, just hold that for a while. Stay with that blankness or disconnection if you can. You see when something has been too overwhelming, one of the ways to deal with it is to disconnect from your feelings. It is a way of coping – a survival mechanism. If you can hold there for a while, and I know it is not a comfortable state because it will stimulate some nervousness… it will get some energy going there… but that blankness is a protection… it has a certain weight to it… emotions attached to it….
Jane: << Jane starts crying now and it is involving her whole body – I let this happen for a little while before I start talking again – giving her some boundaries and containment by doing so.>>
Me: OK, that’s OK… just stay with me… stay with the body when you feel the release of emotion. It’s perfectly fine…. just make sure you are not drowning yourself in it… in the sadness… while at the same time feeling the depth of it… of the emotion…. keep with it so you are giving it some sense of limitation, of containment… and my voice…, my talking to you now helps this… helps to give you some grounding. And you will see that these emotional releases will come in waves… they will subside a little before the next wave comes. Just stay with it, let it pass over you… it will relax some pressure and you will feel different in your body.
Me: How is it going Jane?
Jane: Yes… I am OK. I feel I am surfacing again a bit. I didn’t expect to have so much emotion in me about this, although it has been bothering me for so long.
Me: I understand. I guess you have protected yourself well, not to get too close to this, so as to be able to carry on with your life – albeit having to suffer some form of compromise. Could you tell me what emotions came up for you so strongly and what they related to.
Jane: A lot of sadness really, also shame. Yes, shame. It feels as if that has been bothering me even more than the sadness.
Me: Right. OK. Tell me first: how is the sadness now and where in the body did you feel it; are you still feeling it now?
Jane: I could feel it releasing from the whole of my body but very concentrated around my solar plexus and chest.
Me: Right and how is it now?
Jane: It feels really warm in my body and waves of tingling still. Although I feel there are still parts that we have to work with.
Me: I know… we will get to that shortly. For now, I just want you to give a little attention to that pleasant feeling… that space in your body.. that newness. Let it become an integral part of you.. of who you are now…..
Me: Could you tell what made you feel sad?
Jane: I don’t know really. I think it’s because this whole experience has just kept me from living more fully for so many years. Worse still, every time I had a new partner it took so long for me to let that person come close, especially sexually, and just the weight and pain of it in my body. It sort of took a lot out of me.
Me: Right, that makes sense doesn’t it, what you are saying?…. And all these different emotions are connected to each other. The anger, blame and disconnection kept you from feeling deeper within the body… feeling into the sadness, the fear and the overwhelming shock of the experience itself., thereby keeping the trauma alive. Now let that sink in a bit, on the cognitive level. It is important to work through the emotions and the releasement that comes with it, but it is also important to see how it all hangs together. Once you understand what is involved; when that perspective as to how you look at it has changed, and you can see that what you have perceived and allowed were natural responses, natural ways of coping and you have dismantled the blame and guilt… you will not develop that emotion again. And this is very important – we don’t want you to become dependent on me – going into releases and then the development of that emotion again. Once we have worked through it and put things in perspective it is finished, over. It doesn’t need more work, management, or maintenance, nothing of that kind. Are you still with me Jane?
Jane: Yes, I am very happy that we’re doing this. It’s really helping me. I am a thinking person and this just fits and suits me. Or: (fits me like a glove).
Me: Right. You’re also a feeling person Jane. Now let’s go back a bit to our experience. You mentioned feeling ashamed. Can you tell me a bit more about that?
Jane: <<she is getting nervous now and is hesitant about going further>>
Me: Again, just feel where you are… go slowly into it… firstly, feel the resistance to talk about this, and stay with it for a while. There is no need to use force.. it will come when you quieten down, when the resistance loses momentum. It’s very likely that you’re back again, right now, on that couch with your uncle. You don’t have to go into the details of what occurred, really. It is not all that important. I want you to stay more with, or pay more attention to the feeling, the emotion itself. What’s happening for you now Jane?
Jane: Yes, it feels like I am back there again. He is still touching me and making me touch him. I feel so confused as I know he should not be doing this; it is wrong, I don’t want it, but at the same time I also like it; I’m aroused by it.
Me: OK, let’s slow down here, if we can, because there are lots of scattered feelings happening here and it seems to me that they are quite disorderly……. and also, the meanings that you have given to these feelings are a bit confused… so we want to see if we can untangle them… or put them in their right order. Maybe we should start with the shame, as you mentioned that earlier….. and I want you to go slow with it because I feel that it is there.. just under the surface waiting to take over. Begin by staying with the body sensations…. the flush of heat in the face…. the nervousness….. and see if you can breathe into it… giving it space… till you find that it is not taking you over so much. How is that going for you?
Jane: I am trying to stay with you, following the body sensation but it is hard, I feel it is all mixed up and confused.
Me: I know… we are just working with it, firstly: to give it some boundaries. You see… getting sexually aroused has become something bad for you, something to be ashamed of….. on a certain level…..and it seems like, from what you have told me so far, it is because of this forced experience…… I want you to look at it… also what you told me earlier. – “I don’t want this” but part of you also liked the feelings of arousal…. – this is where the mix up is, it seems to me. Now I am relaying this to you on a cognitive level, just to get it clear to you mentally….but the emotion and shame are still there… coupled with the event. So let’s look at it at a more experiential level…….. I want you to move your attention to the belly, to the groin area… and let your energy go there… your attention. We are going to go slowly into this and I will bring you to the surface, if we need to. Again, be there where we just left off…. in our experience. Feeling sexually aroused… this time, however, I want you to just stay with that… the sensation of it….. letting the event be just what it is….. taking what happened to you when you were so young for exactly what it is…. just follow that feeling, that sexuality…. not letting it take over…. not going into it….. but also not pushing it away…… and this is what has probably been happening in your life….. either you have wanted to indulge in it… lose yourself in it, or there has been this hard refusal to it… that rejection of sexuality…. now I want you to stay with… holding it lightly…. seeing those movements for yourself… this wanting to go into it….. and this pushing it away…… till that becomes lessened. Knowing that the wanting to indulge in it is a reaction to wanting to forget what happened to you, and also the rejection of it is in pushing the shame away….. Keep staying with the sensation, the feeling while I am talking…. I am just helping you to see what’s going on in it… where your reactions are coming from, so that you can let it go …. you can work through it on a feeling level…. and once those reactions…. those wants and don’t wants are becoming lessened… when you are able just to stay with being sexually aroused… the energy moving through the body… the sensations….. feeling the beauty of it…. the simplicity of it…. the feeling it gives you. Experiencing it as a natural feeling, is to be in that natural state….. How are you doing Jane?
Jane: Yes
Me: Are you still with me Jane?
Jane: Yes, I sort of want to stay there… with that feeling a little longer.
Me: I know… there will be time for that… and you can do it now without me.. It’s just our time is running out and there are a few more things to get clear. How is the shame now?
Jane: I think around this it has eased a lot, if not gone completely….. I am still feeling it a bit and also anger towards myself now for not having told my parents what happened then and there.
Me: Right. The anger with it… is it something new or do you feel it just now?
Jane: No only now… I’d always been too ashamed.
Me: OK good… that anger has a certain power to it…. a re-establishing of parameters for you. And we will talk about this a bit more next time. Just for now I want to leave you in that sense of empowerment… that being more here and now. I think we have worked a lot today… we have done a lot. Is this OK for you to leave it at this point?
Jane: Yes… that’s fine.

This is the last of this series of articles. We have gone through the main emotion and mechanism of trauma – both on the cognitive and experiential aspects. In the next sessions with Jane we keep working to process emotional residue related to her abusive experiences as well as repeating the understanding of it on a cognitive level, within herself when there is need of it.

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  • Lana says:

    I think that what you fail to address is that what happened to Jane is a crime – a criminal act that should not have gone unpunished. Anger in survivors is a complex issue and the secondary victimization that occurs when others fail to protect, or to act appropriately upon learning of the abuse is what partly fuels the anger.

    • Roland says:

      Social justice and accountability most certainly has its place but is not part of the intention and content of this website or the work between ‘therapist’ and ‘client’. I am talking about what keeps trauma in place through blame, guilt or self-reproach coupled to an event, person or period in one’s life. It does not justify the aggressor’s behavior nor put blame on the victim but rather focuses on addressing and working through traumatic residue.