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Note: The professional opinions expressed in the answers on this page are given as a general indication and guidance as to what psychological or other factors may be indicated by each question. The answers are not to be seen as definitive. Individual professional assesment and treatment should always be sought to address psychological problems. Whilst we aim to provide accurate information, TTW cannot take responsible for any omissions or errors.

 

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Question 1: Why do I need to re-visit my past, people are making me feel like I am wrong to want some help?

Answer 1: Let me start my reply to this first question by saying that wanting some help to overcome the damage caused by CSA is not wrong, it’s actually very normal. If people are suggesting that you are wrong to want help I would suggest that they are not able to understand your needs.  Every one is a unique individual, so what kind of support or help they need will depend on their individual life experience and whether they are currently having difficulties in their daily life. Having worked therapeutically with a significant number of survivors of CSA, I have not met any that  did not want or need to make sense of the abuse they experienced in their childhood. It can be abusive itself to deny, diminish or negate an individuals stated needs.

Now to answer the first part of this question, without knowing your background, I cannot say I know you need to re-visit your past. However, as you are indicating a desire to re-visit your past it would suggest that any current difficuties you may have could be tied up with early abusive childhood experiences. We all carry around within us the child that we were.  When a child is  abused they try to make sense of what is happening by coming to conclusions as to what the event(s) mean about them, other people and the world about them. As a young child does not have the ability to process information in as sophisticated a manner as adults, they usually come to the wrong conclusions and blame themselves for the abuse, doubt and/or mistrust adults in general and see the world about them as a fearful place. They also then develop coping strategies to manage these conclusions and beliefs, which may work for them as a child but are often not adaptive as an adult.

So for adult survivors the need to go back and re-visit their childhood it is often to to enable the correction of faulty information processing and the maladaptive beliefs that resulted. Learning more adaptive behaviours can also be part of a structured therapy process. This can be very challenging, but unless or until these maladaptive beliefs are changed, an individual can find that they keep repeating unhelpful patterns of behaviour or feel stuck in their everyday lives and relationships. So in conclusion I would say that if you feel the need to re-visit your childhood, you should find an experienced, qualified therapist who is able to help you go back and start the healing process.

 

Question 2: I have found that I am getting overwhelming anxiety at times and I became so angry at a work situation that I would normally have decided to ignore even if it made me uncomfortable. Is this part of the process because I am fearful I may lose my job.

Answer 2: Anxiety and anger are both emotions very much associated with CSA. However, it is not always the case that episodes of either or both are necessarily directly linked to CSA. I would suggest to anyone who experiences significant changes to their emotional state might to try to think about what could have happened in their life recently or any changes in their situation, that might have triggered the emotions that are activated. Anxiety is often linked to fear of not being able to cope with current or future events. Anger can have a many triggers, so keeping a log of when it happens can help to direct the intervention to target the thoughts and behaviours in response to the provocation. In this particular circumstance the person might need to look at what is was about the situation this time that heightened the anger.You suggest that you normally cope with such situations by ignoring them. If we avoid dealing adaptively with anger provoking situations and just bite our tongue this can lead to the anger being internalised and feed depression. It can also contribute to a build up of frustation that leads to an outburst of anger, before settling down again to the ignore/avoid coping strategy and the cycle starting again.

Both anxiety and anger( and many other emotional disorders) respond well to CBT (Cognitive-behavioural Therapy) which is an evidence based psychological therapy. There are some very good self-help CBT books available, such as the   “Overcoming ………..” series published by Robinson which covers most emotional disorders.  As I do not know the background history of the person asking this question, it might well be the case that  deeper underlying unresolved issues, including CSA, might underpin the anxiety and anger. In this case these would need to be addressed to reduce the vulnerability to the triggers of these emotions, probably with the help of an appropriate therapist.

If you are fearful of losing your job because of your current difficulties, a discussion with your GP would be a good starting point to agree what your individual needs are.

 

Question 2(a): Since posting the answer to question 2, the individual who posed the question has provided some further detailed information about her severe abuse background. It would not be appropriate to publish all  this information, so I will summerise the relevant additional detail to the question being asked.  The emotional disturbance described in Q2 is in the context of having found a counsellor whom she is learning to  trust ( previous counsellors were either abusive or unable to help) and therefore trying to let go of avoidant coping strategies to allow the therapy to progress. So the question asked is whether in this context it is normal to be experiencing the emotional difficulties described in Q2.

Answer 2(a): This additional information raises a good point about the therapy process. Most survivors of CSA have learnt strategies to cope with or avoid the often very powerful emotions associated with it. These are often adaptive in childhood but not as an adult. In therapy, part of the process can often be the need to go back   to the abuse and change the maladaptive beliefs I described in Answer 1. Now in order to do this the client may have to let go of  coping strategies that they believe have kept them safe from these emotions/memories. The effect of letting go can lead to a feeling of being exposed and vulnerable with a consequential  increased intensity in anxiety, anger and other emotions. The important issue here is that the therapist and client should work together to plan an adaptive coping strategy, i.e what to do (behaviours) between therapy sessions if there are powerful emotions triggered, especially in the early stages of treatment. This planning is an essential part of the therapy process, especially to keep the client safe and have a sense of being in control. It is difficult to spontaneously think of an adaptive coping behaviour when your emotions are highly activated, so having a written plan to refer to can be very effective. This can include things you might do for yourself, such as self-soothing ,identifying friends or family you might contact or emergency numbers of professional help or specialist voluntary organisations. So the answer to the question posed is yes, it is normal to experience powerful emotions in the therapy process, and as such it is important to expect it and plan an adaptive response.

Question 3: Hi, I have heard some survivors of csa say that they are healed and have forgiven the abuser. I have done alot of work on improving my day to day life and thats better now after 2 years of counselling. But I don’t feel I can forgive and I wonder if I can ever say I am healed… I feel like although my life is better, the abuse cannot be erased and therefore it will always be part of me. Do you think people can erase what happened with healing?

Answer 3: This question raises some complex issues for surviviors of CSA. It is important not to link healing and forgiving, thereby making one contingent on the other. As previously indicated, every survivor has had a unique experience of abuse, and as such, how they view the abuse and abuser will be a subjective judgement. Similarly what constitutes healing will have a different meaning to  each individual. Therapy can help to heal  the emotional damage of the abuse and  reframe the meaning of the event to reduce the emotional impact on day to day living. It has been my clinical experience that most survivors do not have a goal in therapy to be able to forgive the abuser and nor should it be seen as failing if you aren’t able to. CSA is wrong no  matter what the background circumstnces of the abuser. It can be helpful to understand why and how the abuser made you a victim but that does not mean they have to be forgiven. Therapy can help someone to move from victim to survivor and get on with their lives in a more adaptive manner. It is not realistic to expect to erase the memories of abuse, and it may be the case that in trying to to do this it in some way invalidates the abuse experience .Emotionally powerful life experiences, both good and bad do stay in our memories, and it is how we store them and what they mean to us that will affect our day to day living.

Question 4:  hi, I am a CSA survivor & have more good days than bad lately, having worked very hard in therapy. I still struggle massively with trust & control though, if I feel I have lost these then I quickly feel upset, desperate & angry……….is there anything I can do to improve this? I have very few friends, no family support & no partner. Thank you

Answer 4: Trust and control are obviously major issues for survivors of CSA. Both of these are fundamental to the abuse experience and when triggered as adults they can produce very powerful  emotions as you are describing. You mention having worked very hard in therapy and having more good than bad days, which is good progress. It is not clear whether you are still in therapy, but if you are the issues you raise need working on with your therapist. I would hypothesise that the emotions being activated are possibly indicative of some maladaptive core beliefs/lifetraps that have not been fully addressed in therapy so they get triggered  in certain situations, circumstances and environments. There is a self-help book called Reinventing Your Life by Jeffrey E Young and Janet S Klosko which can help to identify any lifetraps you may have, and then has specific chapters to help you work on them by yourself or with the help of an approppriate therapist. You appear to have made progress to date so it may be that you have a little more therapeutic work to do to resolve the remaining issues.

Question 5:How do I know who I can trust to tell about my past, some people will be okay with it and I think some people won’t. Is there a way to know who to tell? Difficult to decide thank you .

Answer 5: Another very good question about trust which raises some very complex issues. Much as I wish there was a simple answer, this is not the case. I suppose the important starting point is that trust is something that has to be earned by an individual. Trusting someone with very personal information about yourself is something we need to be as sure as we can they won’t abuse. As you say, some people with be ok with it (the knowledge of your past) other people may not. There are two elments to this – they are ok with the information and keep it safe (or not), or they can handle hearing the information about your past, or not.

Now for the first element as I indicated earlier, in order to check out whether we can trust someone, we will probably need to know them over time so that they can earn your trust by behaving towards you in an appropriate manner, showing respect and being honest and genuine. There is also an intuitive element to it, i.e a ‘gut feeling’ about a person, but we need to be careful about putting too much weight on just this if we have maladaptive core beliefs/lifetraps, as mentioned in answer 4. If you are unsure about whether you can trust someone, it is better to wait until this uncertainty is resolved before confiding in them. It is healthy and appropriate that we do not tell anyone too much too early on about ourselves. We need time to get to know them and for trust to develop. Our self-disclosure is usually a gradual process as we share information with others and they share in return.  This interaction and the responses we get from sharing will help us to guage how far to go with self-disclosure with any particular individual. Sharing too much too soon can escalate the risk of the information shared being abused. If you are engaged in therapy with a qualified professional, it may be that this process of self-disclosure is shortened, but the rule still applies  that you do not risk sharing details until you believe you can trust the Therapist.

The second element is whether someone can handle/cope with the detail you are sharing i.e be overwhelmed.  If the steps in the first element  have been followed then you would get a good idea what it is appropriate to share, as the level of self-disclosure increases over time. It is the responsibility of the individual to indicate what level of self-disclosure they are comfortable with and so set the boundaries in the relationship.

You are right to say it can be difficult to decide who to trust, especially for survivors of CSA.  Trust has to be earned and this takes time, so aviod rushing in too far too soon with the self-disclosure.

 

Question 6: I have just struggled through another weekend. I am finding weekends very difficult, they remind me that I am single, they remind me that I am not surrounded by family. I feel like everyone around me is having a lovely time…and I am not :( What can I do to make it better?

Answer 6: This question raises a very important and sometimes unrecognised problem that survivors experience. Isolation and loneliness can be a consequence of difficulty retaining and maintaining relationships with close or immediate family members and establishing healthy relationships with others as a result of CSA. As mentioned in answer 5, trust plays such a huge part in connecting with others and for survivors it can feel safer not to get too close to avoid getting hurt or taken advantage of.

Unfortunately some survivors can also find it very difficult spending too much time on their own with too much thinking time, when thoughts can tend towards the negative and pessimistic. You say “I feel like everyone around me is having a lovely time .. and I’m not.” Whilst it may appear like that, feelings aren’t facts, and although some around you may be having a good time many others  may just  be having a so so time or even a not so good time. Most people if they spend too much time alone will eventually find it emotionally challenging to cope with.

How a survivor manages this kind of problem will depend on what their goals and needs are regarding family/friends/relationships, and their individual circumstances.  My clinical experience has shown that survivors can sometimes find it easier if they don’t live on their own, i.e. share accommodation with someone else/others which can help to reduce time spent alone.

Another strategy is to try to engage in social activities where healthy friendships can develop, such as adult education classes, volunteering or special interest groups. These can offer the benefit of a regular activity from which friendships can develop and additional social activity can grow from this.

The way your question is phrased suggests you may be feeling disconnected and left out of what others are experiencing. Focusing on establishing healthy relationships and activities can help to reduce the loneliness and isolation. If weekends are the most difficult, ( as it may be for many) it would be appropriate to focus on establishing regular weekend activities, perhaps with others, as a starting point.

If this appears too daunting to tackle on your own, it may be that some professional support might help to get the ball rolling.

Question 7: Hi Chris, This question comes via and on behalf of the peer to peer group… How can survivors learn to accept their body, learn to care for and be aware of its needs rather than treating it like the enemy. It is hard to like something that was not only not valued but made to feel like rubbish. Surely it requires a whole turn around in our thinking and takes a long time?

Answer 7: This is a very good question and goes to the heart of the damage that results from being abused as a child. This is not a question to which there is a simple answer, but stay with me and I will try to do my best to explain the basis for this problem!!!

Accepting and nurturing your body as an adult when it is something that was treated in such an abusive manner when a child requires a significant shift in the emotional connection we have with our physical self. We all carry within us the child that we were. If a childs core  needs for a safe, secure and nuturing environment with unconditional love and acceptance are not met, it is likely that this child self will not be healthily integrated into the adult we become. There can be left a sense of defectiveness and shame associated with the abuse/unmet needs, which manifest themselves in the adult with powerful emotional responses and dislike/ disgust of our physical selves because it reminds us of the abuse and unmet needs. The powerful emotions that get triggered are indicative of the vulnerable,angry or undisciplined inner child with unmet core needs. In order to help  this neeedy child be healthily integrated, it needs help to have it’s core needs met. This is about self nuturing. It is important to remember that as a little child it was not your fault that  parents/carers failed to protect you from abuse. The little child needs to hear that they were a lovable and good child who was failed by the adults around. This can be done, for example, by writing a letter from your adult self to your damaged inner child, telling them what you know now about what happened to them and that it was not their fault, and that you love them and will look after them from now on. In therapy we use imagery to access the inner child and rescript the beliefs the child has about themself which can prevent the adult from liking themselves and self nurturing. The book I mentioned before “Reinventing your life” has chapters on this. Kate Swift is well aware of this process as we worked together in therapy to enable her to nuture the very damaged little Kate she  carried around inside her. Depending on how damaged the inner child is, you may require some professional help to to nurture the child. It is not a quick process to make changes, but if you can start to self nurture/pamper on a regular basis because you deserve it, it is a good start.  It does not have to be big things, a long bubble bath listening to some favourite music, having a manicure/professional makeup, treating yourself to  a show or special meal or new clothes, can be helpful. The important thing is to learn to love yourself unonditionally  because of who you are, and not to reject the inner child who was a victim and now needs to be healed. Additionally, self-help books such as “overcoming low self-esteem” by Melanie Fennell can help you to understand the whole person you are, and challenge the distorted negative image  that maintains our difficulty accepting who we are.

Question 8 :I have been diagnosed with DID. Can I ever get better or will I have this forever?

Answer8 : Dissociative Identity Disorder (DID) (previously called multiple personality disorder) is a common severe effect of trauma in early childhood, including physical, emotional and sexual abuse. DID is a severe form of dissociation, a mental process which produces a lack of connection in a person’s thoughts,  feelings, memories, actions or sense of identity.  The dissociative aspect is a coping mechanism where the individual literally dissociates themself from a situation that is too violent, traumatic or painful to assimilate with the conscious self.

The number of personalities a person diagnosed with DID may have will usually grow as treatment progresses. It is not uncommon for a dozen or more to become known from a starting point of less that 5. It has been known for as many as 100+ to be identified in some individuals.

Now in answer to the question,  it is thought that long term treatment including psychological therapy and medication can be successful if the client can manage to stay with the treatment. Most people with DID will have been in the mental health services for some years before they are diagnosed with DID.   Once they get such a diagnosis it would be hoped that a referral to an appropriate service would follow.

There are many books available that explain the disorder and it’s treatment in detail so it is worth a search on the internet if you want to know more.

Question 9: I was abused by a family member as a child. I didn’t tell anyone and only couple of people know now, over 30 years later. I know it wasn’t my fault but why do I still feel so guilty and unable to say anything? I know what happened but I blank it out or make out it didn’t really happen. But it did. I’ve suffered depression, self harm, eating disorders, attempted suicide… I still struggle with intimacy but feel like I’m making excuses. Is this normal

Answer 9: This question encapsulates the common experience of survivors of CSA.  Difficulty disclosing abuse at a young age and beyond is understandable. As a child it is difficult to make sense of the abuse (see Answer1) and the victim/survivor may have all kinds of fears of the consequences and repercussions if disclosure is considered. The non-disclosure of the abuse is therefore part of a coping strategy as are the other behaviours and mental health problems you detail. From the current difficulties you are describing, it appears you still have a number of unresolved issues relating to the abuse which will probably need addressing in therapy. Until the damaged inner child is helped to heal, the current coping strategies are likely to be activated at certain times, situations or in response to triggers. Whilst the coping strategies often work in childhood, they are often not helpful or adaptive as an adult. Difficulty with intimacy is entirely understandable for a survivor, especially sexual realtionships as the link to abuse is obvious and can trigger very powerful emotions.

The struggles and conflict you describe are normal for a survivor. You do not need to feel guilty about the difficulty of disclosure or feel you are making excuses to avoid intimacy or anything else. You are a survivor of CSA and need to be kind to yourself and seek the therapy that may help you heal and find more adaptive coping strategies.

 

Message:
Question 10:   I have a problem that I am struggling to come to terms with who I
really am. I have a tendency to destroy the good things in my life. I
think I know why but I do not know how to change this aspect of my
personality. Anyone who gets too close to me I push away before they
can run, that way I lessen the damage to myself but in turn cause damage to the other person involved which is wrong on so many levels &
in a way makes me an abuser of sorts doesn’t it. I can see that this
is bad but how do I change it?

 

Answer 10:  My first reaction on reading this question was to think how typical this sort of problem is with survivors of CSA.  Forming healthy relationships and coping with intimacy can be very difficult when abuse of trust has resulted in the abuse of the child. It is understandable that if you fear rejection, abuse and abandonment (possibly others) as a result of childhood experiences, that rather than risk getting hurt physically or emotionally you get in first by pushing away/rejecting people who want to get close to you in a healthy way. The problem with the coping behaviours and rules for living you learnt as a child is that they tend to be a one size fits all and are fixed and inflexible. It does not make you an abuser as you are only doing what you think will keep you safe. As indicated in some of my previous answers, the coping strategies learnt as a child often do not work in adulthood. Consequently there is a need to learn more adaptive responses, to avoid repeating maladaptive behaviours. More of the same (plan A) results in more of the same in terms of outcome. An alternative plan B is needed in order to secure healthier outcomes.

The first sentence in this question raises an important point. If anyone is not sure who they are, it suggests there may be unresolved, deep rooted issues . My clinical experience suggests that such an individual may have some underlying maladaptive core beliefs (rigid/inflexible) that need working on. Unless or until these maladaptive core beliefs(lifetraps) are replaced by more adaptive and flexible  ones, the individual is likely to repeat patterns of behaviour that don’t produce the desired outcome.

If you read the book ‘Reinventing your life’ which I have mentioned in previous answers, you can explore whether you have any maladaptive core beliefs/lifetraps that need working on. It’s a self-help book which gives guidance as to how to assess and work on any lifetraps that may be identified. It may be that is all you need to help you understand and change what is indicated. As always, it can be helpful to have a therapist ( appropriately qualified) to help you, especially in the beginning. On reading the book you will probably get a sense as to whether you think you need professional help.

Question 11: Chris, my question relates to sexual orientation. I experienced sexual
abuse as a child/teen by a male perpetrator and very soon afterwards
pursued a relationship (and married) a man who was also abusive. Those
are the only two intimate relationships I have ever had with males. I
eventually extracted myself from the marriage and am now happy and
settled with a female partner, but I sometimes feel that this was less
of a choice to be with a woman than it was a need not to be with a
man. Is it common for CSA to shape or influence sexual identity? Thank
you for your thoughts.

Answer 11: This is a very important question and one that has no simple answer.  The debate about the origin of an individual’s sexual orientation, nurture vs nature etc. still continues, although perhaps nature rather than nurture is ahead in the debate.  Now as you describe having been sexually abused by a male as a child/teen and then entered a relationship/marriage with an abusive male, one could argue that you have been conditioned by these aversive experiences to avoid any further relationships with men rather than risk further abuse. That would be a nice simple explanation, but it’s more complex than that. CSA does have a significant impact on how we see ourselves as sexual beings and whether we are able to engage in any particular kind of sexual experiences, if at all. Whether it affects our sexual orientation comes back to the nature vs nurture debate again.

I am sure many of us know individuals both male and female (I can think of three, none of whom were clients) who had been in non – abusive heterosexual relationships, had children and then moved out of the marriage and into a homosexual (gay) relationship. This perhaps is evidence that our sexuality is not necessarily fixed at any particular point, but exists on a continuum with heterosexuality at one end and homosexuality at the other.  It would therefore be possible to move along the continuum (or not) at different times in our life, depending on our individual needs. You describe being happy and settled with a female partner, which is a crucial point. That being the case, it is important to enjoy what you have in the here and now.  If anything happens to alter that in the future, it may then be appropriate to explore what caused the change in the relationship and review what your needs are. If you still feel the need to explore your own sexuality now, a specialist psychosexual therapist may be of help.

I am sure you and others reading this are aware of RELATE(UK) who offer specialist professional help to couples, heterosexual and homosexual who want help to sort out their problems, including sexual issues.

Question 12: After 30 years of marriage we are dealing with the sexual abuse again.
I know i shouldn’t pressure him for sex. but I feel completely
rejected by his need to watch porn and satisfy himself. We have
discussed the negative affects of porn but he still goes back to it.
What is the most supportive way of addressing my issues with this.
Right now I kinda just freak out, that can’t help.

Answer 12: Addiction to pornography is a problem that appears to be growing as access to it becomes increasingly available, often at the click of a button. I recall attending a workshop around 10 or so years ago, run by a respected American Psychologist who has advised the US government on issues related to CSA. She made it clear then that addiction to pornography  was likely to become a major social crisis around the world as the availability of it became more widespread.

Of course you have the right to expect a healthy relationship with your partner, including sex. You are correct in labelling his behaviour towards you as abusive, as indeed it is. You have tried to talk the problem through, but he is drawn back to the abusive behaviour.  It is important that you remember that it is his problem, which he has to take responsibility for. If he values his relationship with you then he should be willing to seek help for his addiction. You can support him in seeking help with his problem, but not support him in continuing with what you experience as abusive behaviour. I can understand why you “freak out” in response to the way he behaves, as his inability to stop the abusive behaviour can potentially trigger of  powerful thoughts and feelings associated with CSA.

If he wants to change (and he has to want to change) then he could start by talking through his problem with his GP, who could then discuss the possible help available. It may be worth contacting RELATE to enquire whether they are able to offer help to you as a couple also. If he is unwilling to seek help you will have to think about what your bottom line is, and the cost to you of remaining in the relationship with the current situation remaining unchanged.

 

Question 13: I have self-harmed since the age of 8. 33 years now. How can I get

help and what can I do to break the cycle? My self-harm has often been

life threatening in the past 4 years or so.

 

Answer 13: Self – harm is usually  indicative of significant unresolved psychological trauma which causes very strong emotional reactions to particular situations or events, and the need to diffuse the psychological pain by self-harming. The fact that you have been stuck in a self-harm cycle for so many years indicates that you need professional help with the underlying and unresolved problems. My experience of working with clients who use self-harm to cope is that it is essential for them to work with professional(s) to address their problems, as most have tried for many years to cope as best they can, but their solutions are not effective. You have indicated that some of your self-harm behaviour in the past 4 years has been life-threatening, which suggests that emergency services and/or health professionals have been involved at some time. My advice to anyone who uses self-harm to cope is to see your GP and ask for help .In an emergency you should of course use the A&E department at the hospital.

Self-harm is not something that will just go away as I am sure most survivors who have in the past or currently self-harm will know. Breaking the cycle of maladaptive coping strategies is a complex process, but with the right guidance the cycle can be changed to something more healthy and adaptive. Don’t struggle on alone, ask for help!

Question 14: How do i help and support my husband when his son has raped my daughter and his daughter witnessed this rape 7 yrs ago and only now has a complaint been made to the police. How can our family ever come thru such an ordeal and be a strong family unit again?

Answer 14: This is a very complex and difficult situation to manage and find a way through.   The phrasing of the question leads me to assume that your husband’s son and daughter are from a previous relationship. I would also assume that as the police are now involved they will have informed, and be liaising with the appropriate statutory authorities. Putting aside the legal processes, the main thrust of your question is about the family surviving the ordeal and finding a way to heal.

I would suggest that you will probably need help as family unit and individually, to come to terms with the reality and trauma of the disclosure and the changed family dynamics. The initial response to such disclosures usually causes chaos within the family structure, with a mix of powerful thoughts and emotions being experienced.  It may be difficult for individuals to offer support to other family members while they are still trying to process their own thoughts and emotions about the disclosure.  Your daughter who has been raped should, I hope, be offered specialist psychological help to deal with the trauma of such an abusive experience.  The abuser will no doubt be dealt with through the legal process. The daughter who witnessed the rape will have her own needs, and as a potential witness in any legal proceedings may find having to describe what she observed emotionally challenging. As parents of those involved and as individuals you will both have your own issues to deal with, which will be mediated by your own life experiences, coping strategies and skills.

I would therefore suggest that you may all initially benefit from some individual professional support, and if wanted, collectively you could benefit from some family therapy sessions. When the initial chaos starts to subside and the due legal process has taken its course, the healing can progress. It will be a complex journey, but with the right support it is one that can lead to a recovery over time, with family bonds strengthened.

Question 15:Please has anyone got any words of consolation/advice/comfort to give to a victim/early survivor who’s dad (1 of the perpetrators of abuse against her) who is dying. She loves him, respects him and is very sad. I know how to comfort someone in grief, just think this will be more complex with more layers of emotions involved for her and family Thankyou in advance.

Answer 15: You say that you know how to comfort someone in grief, which will be of great help to this person. You are correct that this is going to be a more complex process due to the fathers’ role in her abuse. From your description, the individual concerned has come to a place where she is able to love and respect him so maybe has already worked through some issues between them. If there are any unresolved issues it may not now be possible or appropriate to raise them at this stage.  Her sadness that you mention could be indicative of the start of the grieving process.  As you may be aware, it is suggested there are five stages in the  grieving process,(denial, anger, bargaining, depression & acceptance) and it may be in this process that conflicting thoughts and feelings arise for her and her family after his death. The important thing is to acknowledge that this is understandable and normal and allow for them to be expressed and processed. The loss of a parent who is also perpetrator can be very confusing and it may take some time to come to the final stage of grieving, which is acceptance.

Question 16: It has just been exposed that my dad is a paedophile who raped my
older sister when she was 4. He has been arrested and bailed pending
an investigation due to lack of evidence.

My son who is now 9 has been in the house with both my dad and my mum.
I need to know, how would I know if something has happened to my son.
Would he tell me? I have asked him calmly and he has said no. How can
I know for sure. We are close so I feel like he would be able to tell
me. But what if something happened when he was little. Maybe too
little to remember. Is this common. Or do children always remember
abuse.

What if he abused me and I can’t remember.

I’m 7 months pregnant and the stress of this is unreal. I am so very
angry that I would like to kill him with my bare hands. When I
confronted him he denied that he is a paedophile but later admitted it
to my mum.

I attacked him when questioning him and hurt him quite badly. I keep
having flashbacks of this. I feel guilty for attacking him. But why do
I feel guilt when he raped a child.

Please help me.

 

Answer 16: I am sorry to hear of this dreadful event in your family. As it has only just come to light the shock of finding out will take some time to subside. The anger you are expressing is to be expected and normal in response to such a reported crime. It is also natural to question all relationships between the abuser and other family members as you try to come to terms with a changed understanding of your father.

If your father has been bailed, is it due to  lack of evidence or to allow for futher investigation to follow leads and secure the evidence? As you indicate he has admitted to your mother he is a paedophile?

The questions you ask about the risk of your son or yourself having been abused without remembering does not have a definitive answer. Sexual abuse is a traumatic experience for the victim, so the memory of it is retained and stored as such.  Younger victims who do not have the vocabulary to articulate abuse will often demonstrate behavioural changes that indicate something is wrong.  You describe having a close relationship with your son so were well placed to pick up any signs of distress in earlier years, as were others having regualar contact, including those at school. He is now old enough to be able to tell you if any abuse took place and says it didn’t. So at present there is currently no evidence to indicate he was abused. The same  applies to you to.

Your anger towards your father, and confusing feelings of guilt for having attacked him are understandable. Whilst you want revenge for his crime and failing as a parent, there is also a bit of you that still connects to him in the father/ daughter relationship.  I have heard of this confusion from many victims. It is important to remember that what he did was wrong and destroyed all trust and negated any rights he may have had in his relationships with those he has betrayed.

I hope that you and your family are able to obtain the support that you need to get through this terrible ordeal. It may be helpful to talk to your doctor to discuss what your needs are so that they can help you access appropriate skilled help. The police may also have made suggestions of agencies that might help in these situations.

As indicated in my opening sentence, this will be a chaotic period for all concerned and it may take some time until the shock and associated thoughts and emotions begin to subside. Use whatever resources are available to help you through this chaos and over time healing can begin.

I wish you well.

Question 17: Message:

Hi. My friend experiences loss of time in which she cannot remember

anything. To our knowledge this lasts anything from half and hour to 9

hours or so. When I have been with her I observe that she reverts back

to childhood and is as a child. She does not recognise me, her home,

anything, and is very confused. I have learnt that the best way to

deal with it is to reassure her and treat her as I would a young child

until it passes. Sometimes this has been brought on by intense

flashbacks/nightmares, police videolinks, but other times there

appears to be no trigger. She worries that this will come on when she

is out alone and worries saying that “I can’t let a child out on her

own”

Our concern is how vulnerable she is when in this condition and that

people may not understand why an adult is behaving as a child and may

not respond in a helpful way.

My friend is very confused about why this happens. We have some info

on why but the main thing is can it be predicted and what can be done

to help her manage it?

She has a Cpn and a therapist. She finds it hard to communicate these

experiences to them although she tries very hard to express herself as

she does not understand what is happening herself. She is a survivor

of CSA and diagnosed with BPD.

Any advice you can give would be greatly appreciated.

 

Thankyou

 

Answer 17:  I’m not sure I am able to give a comprehensive response to this question. The reason I say this is that without a detailed understanding of the history of your friend and treatment interventions tried in the past and currently, I can only respond in general terms. As she has a CPN and a therapist she has probably been supported by professionals for a significant period of time. It is certainly a difficult disorder for you to manage as her friend, and you can only do the best you are able. Ultimately the professionals have the responsibility to manage any risk associated with her disorder, and should agree with her a plan for emergencies.

Keeping a diary of when these episodes occur (which may be dissociative states) can perhaps help to pick up any patterns and triggers that may not be apparent at the time.  You say she worries that it might happen if she is out on her own, which suggests this has not yet come about. Part of her plan for emergencies could be how she manages/avoids such situations. If it has not happened when she is on her own it may indicate that the child state is only activated when safe to do so, i.e. when others are around.

Could she perhaps speak to the professionals involved in her care and give permission for them to advise you how to support her care plan, including managing these episodes if they occur when you are around. Any input you may offer to help her manage these episodes needs to be guided by the overall care plan that the professionals and your friend have agreed, to ensure consistency.

The fact that she has a therapist would indicate that she is getting psychological treatment to address her personality disorder, which should in time minimise the likelihood of such episodes occurring.

 

 

Question 18:

Hi, I have just found a counsellor to help me deal with years of

severe csa as a boy. But Im wondering how long this will take, I

anticipate a few months at the most? Is this realistic? Is there a set

time frame to fix this stuff. Thanks.

 

Answer18:

I am pleased that you have found a counsellor to help you with the CSA you experienced as a boy.

You have asked a question that I am often asked at the beginning of therapy during the assessment session, i.e. “how long will the therapy last or how many sessions are needed?” Everyone entering therapy is a unique individual, with a presenting problem that requires a thorough assessment and a clear explanation from the therapist as to the proposed therapy intervention. You have indicated how long you anticipate the therapy will last. I would imagine your therapist has given you some idea about treatment length following assessment. It is not clear from your question whether you have actually have had your first session yet, so if not, it is a question you could ask at assessment.

In my clinical practice I discuss with clients an agreed number of sessions at which point we review progress (although the model I use assumes an on-going review, session to session). At the main review we will discuss progress and contract for further sessions if appropriate.

I cannot say whether a few months is a realistic time frame, as the assessment process informs the treatment intervention and timescale. CSA often leaves deep psychological trauma and disorder, so the nature and extent of this should help you and your therapist have an idea about what treatment is needed. In GeneralThe more complex the problem the longer the treatment process.

Given all that I have said so far, you can deduce that there is no fixed time frame for the therapy process. The model of therapy engaged in will affect the number of sessions and time frame, for example some have an open ended approach and others are more goal oriented/focused. Therapy can last from weeks up to years; the important issue is a good therapy relationship with the therapist and a belief and evidence that the therapy is effective for you. Don’t be afraid to ask your therapist questions about the therapy process, or indeed to express any concerns you may have about it’s efficacy.

I wish you well with the therapy.

 

Question 19:

I feel like i am weaker than others as i cant seem to move on as

easier as other people. I used to go to counselling at a place called

axis which just deals with adults who have been sexually abused as

children, but i am now missing it, is this normal cos i dont think i

coping to grand. My sessions with them have finished and i cant go

back cos they have already had me back twice and cant really go back,

dont think they would have me back anyway,

 

Answer 19: I am always concerned when I hear the use of weak and strong in the context of therapy. Psychological and emotional distress is not the result of an individual being strong or weak, nor is their ability to benefit from therapy. You use the term counselling for the sessions you have had with Axis, an organisation I am not aware of. Counselling means different things to different people. I assume that Axis has specialist trained counsellors/therapists to work with survivors of CSA?

It is likely that you will miss the support of a therapy relationship, even if the therapy has not dealt with/healed the underlying problems associated with the abuse. The fact that you have needed to return twice for further sessions suggests that either the therapy approach they use is not the right one for you or the therapy ended too soon. My clinical experience indicates that most survivors with a complex background will need longer term therapy with an experienced therapist who is using a theoretical approach that is known to be effective for survivors of CSA.

 

You say you “feel” like you are weaker. Feelings are not facts; they are usually an emotional response to thoughts passing through your mind, often in as a reaction to events and circumstances. Perhaps you have had thoughts about “failing” relative to others “succeeding” in their counselling/therapy? Moving on psychologically is about effecting change, and the changes required by each individual will be different.

 

It appears from your question that you would like to have more therapy.  I don’t know what local resources are available where you are, but there should be some kind of NHS service. Your GP or local mental health team should be able to point you in the right direction.

 

You are not weaker than others, you just need to find the right king of therapy for you!

Question 20:

I have been referred to various places (including the priory) for
anger management courses by therapists in the past. They have all said
that I am a very angry person, yet as I never get angry outwards,
these courses have never worked. I don’t see myself as being angry
person. What do they see that I don’t? My anger shows in my self harm,
but that is just against myself so it’s not real anger is it? Do I
need to find the real anger to get help? For me, anger means violence!

Answer 20:

The last two sentences, one a question and one a statement, go the heart of the overall question. It would appear from what you have said that you don’t express anger as that equates to violence. Perhaps there is also a fear of losing control of your anger which may lead to violence? This fear can fuel avoidant coping behaviour which my involve suppressing any anger. Anger does not have to lead to violence. There are healthy/adaptive responses to feeling angry which do not involve violence. Those referring you for anger management may  have identified suppressed or internalised anger in you and decided that anger management might be helpful.

Anger is a normal human emotion we can experience when our own rules for living (adaptive and maladaptive) are violated, or we feel demands are being placed on us that we don’t believe we have the resources to meet.

Self-harm is a means of relieving psychological distress in the moment, but it does not address the underlying psychological problems, hence repeated episodes of self-harm. It doesn’t necessarily have to be anger driven.

Finding the cause of any internalised/suppressed anger or distress is important so that it can be addressed and a more adaptive coping strategy developed. Internalised or suppressed anger can feed depression.  My clinical experience of working with survivors of CSA suggests that there is often anger residing in the abused child relating to unmet need at the time of the abuse, including that of the right to have a safe, secure and nurturing environment in which to develop. In therapy, the angry abused child needs to be able to deal with this unmet need which will in turn heal the unresolved issues around the abuse and the internalised anger. You do not state what model or the extent of the therapy you have had in the past, but perhaps help finding out the cause of the identified anger may be the starting point to addressing it. Help expressing any supresssed anger can be cathartic and therapeutically very effective.

Question 21:

I was abused from the age of 2 until 13. This was done by many people

including my gp and a policeman. My mother knew about the abuse and

instigated some of it. My problem is with friendships. I make quick

friendships which I think are “deep” then when people don’t phone me

when I think they should I feel overly hurt and just want to push them

right away. How can I get over the feeling of all or nothing? Why

can’t I just trust people?

 

Answer 21:

This question raises a very important consequence of CSA, that of the loss of trust and difficulty choosing healthy people with whom to form relationships and indeed how to have healthy relationships! In answer to your last question, (how could you ‘just’ trust people) I would say that when a vulnerable child has its’ trust in adults betrayed in the manner you did, how can you risk trusting anyone? The problem you describe with friendships is understandable given your unmet needs as a child. The desire for friend you can rely on and trust is something we all need. Deep/close relationships develop over time as we gather information about a potential friend or partner which suggests they are reliable, honest, respectful and trustworthy amongst other things. Your response to not receiving a telephone call when you expect it is indicative of feeling let down and abandoned by the individual, even if they have not intentionally done either of these things. There is also a process that we call schema (lifetrap) chemistry(buttons being pushed) which can play a hidden role in attracting you to people who behave in the very manner you don’t want. I have worked with a number of clients to draw up a list of warning signs in potential friend/partners that may indicate they are being drawn in for the wrong reasons.

The details of your question indicate that you may still carry around the abused child within you which has unmet needs that require an experienced therapist to help you meet. In my clinical work I use imagery and re-scripting in order to facilitate the meeting of the child’s needs which allows for the healthy integration into the adult.

If you have already had therapy to address the CSA, the lifetrap book illustrated under answer 10 can help identify any lifetraps you may have that are affecting your life now ( abandonment for instance) and how to set about changing them. I should point out that most survivors will have many of the lifetraps listed,(pre- treatment/therapy) it is very rare that a survivor has just one or two.  It may be that you also need professional help to make some of the changes recommended.

See answer 4 which has also addressed trust issues

 

Question 22:

Message:
My boyfriend is a survivor of child abuse, he finds a lot of comfort in
sex and says it makes him feel loved and not be upset about what
happened to him. I’m having trouble coping with how heavily our
relationship and his treatment of me depends on sex. If I don’t have
sex with him he won’t speak to me or treat me nicely and has gone as
far as to threaten suicide because I’m not giving him what he needs. I
tried to talk to him about this but he says I’m making him feel guilty
about sex and like a rapist, and then he won’t speak to me until I
have sex with him again.

This has been on-going throughout our relationship and I don’t know how
make things better, is there anything I can do to make this better?

 

Answer 22 :

I feel I must start my answer to this question with a very clear statement. Nobody has to have sex if they do not want it. We all have the right to place limits and boundaries around when we choose to engage in sexual activity. Anyone who is coerced or forced into sex against their wishes is having their rights violated and abused. Your boyfriend may well get comfort in sexual activity with you, but he is using it as a maladaptive coping behaviour to manage the unresolved issues from his childhood abuse. If he doesn’t deal with the underlying damage, this maladaptive coping i.e. sex to deal with psychological distress , is only good until the next time he feels the need for comfort and to feel loved. Sex is not the solution, is has become part of the problem. It doesn’t matter how many times he has sex, unless he deals with the underlying and unresolved psychological damage from the childhood abuse, the sex is only a very short term fix to feel good.

 

I don’t know how long you have been in a relationship with this man, but what you describe is not healthy for either of you. You describe your relationship and his treatment of you as dependent on having sex when he needs/wants it, which is dysfunctional.  The emotional pressure he places on you in order to obtain your compliance with his sexual demands is abusive and unacceptable. Threats of suicide are concerning, but in a healthy relationship they would not be used to gain compliance with unreasonable behaviour.  I am not surprised he feels guilty when you try to talk to him about it as he has to face the fact that he is violating your rights to make your own choices about your own body.

 

It is not your responsibility to make things better for him. He needs help to find a healthier way to feel loved and less distressed about the abuse that is adaptive and allows for a healthy relationship based on mutual respect for each other. He will almost certainly need some professional help, but he needs to take responsibility for his own problems.  It is appropriate for you to support him in the process of getting help, but he has to be motivated to seek it. Whilst it may be difficult for you, by not giving in to his inappropriate sexual demands (applying your limits and boundaries) and encouraging him to seek professional help, you will contribute towards breaking an unhealthy cycle of behaviour on his part. If he does not get help, the current dysfunctional pattern of the relationship is likely to continue.

RELATE also offer help to couples with relationship difficulties, so this could be pursued if both are in agreement, but I would expect he will need individual help alongside any couples therapy.

 

Question 23: Is anyone aware of behavior in which a person will purposefully store

food secretly in order that the food rots. And they keep it there as

like ‘a shame cupboard’? As a secret shame. Even if they keep the rest

of the house spotless.

Sorry if this sounds out there. Genuinely interested if anyone knows

more about this type of thing.

It is in reference to an adult survivor of childhood abuse.

The person is very clear and certain (as am I) that this is not eating

disorder related.

Many thanks :)

 

Answer 23:

 

This is a difficult question to respond to as I would need to complete a detailed assessment with the individual  to establish  the onset and history of the behaviour. It seems to suggest that this behaviour is externalising feelings of badness/shame and trying to separate them from the rest of the person/self. Shame is a common experience for survivors, and overcoming feelings of shame are part of the healing process. You are right in that what is described is not an eating disorder, assuming that the individual is otherwise eating normally and maintaining a healthy body weight.

 

Without the individual history behind this problem it would be inappropriate to speculate a treatment intervention. I would suggest that seeking professional advice/assessment in the first instance would be wise, this may then help to establish a formulation of the behaviour that can then inform a treatment intervention.

 

Question 24:

Hi Chris. My inner child wants to be mothered. I do my best I think. I

have noticed that with some of my friendships she identifies the

person as a “good mummy” type and wants to earn their approval by

doing and saying the “right” things, and by being “helpful”. This

leaves me feeling confused, do I like the person etc or am I being

unconsciously motivated by my inner child. Also when she thinks

someone might be a ” good mummy” to her she is vulnerable to feeling

hurt and rejected which I feel holds me back from being relaxed in the

friendship. I am struggling with this. Any advice?

Thanks

Answer 24:

This is a very good question  about the issue  of unmet needs in childhood. Every child has the right to expect that its need for a safe, secure and nurturing environment, as well as unconditional love and acceptance will be provided by their parents/carers. If these needs are not met, the child is carried around by the adult and will keep trying to get the needs met. I am sure you try to meet you inner child’s needs, but what you are describing suggests something is being missed. If certain friends are experienced by you as “mummy types” and therefore potentially nurturing, seeking their approval in order to try and get your inner child’s needs met is understandable. Your feelings of vulnerability are probably related to trust and the fear of being let down, disappointed or even abandoned.

The key issue here is finding a way to permanently meet the needs of the inner child. If you look at the book “re-inventing your life” (see bottom of Answer 10) there are strategies outlined for identifying the specific unresolved childhood issues and approaches to healing/meeting the needs of the inner child. You may find you are able to do this work on your own or you might need the help of an appropriate professional to work with the inner child’s needs.

When the needs have been met, the child will be healthily integrated with the adult self and the emotional triggers should dissipate.

 

Question 25: What if a child is confused, and feels that the sexual attention is a
good thing compared with everything else in their life and so gives
mixed signals? Does this make it their fault?

Answer 25: It is never the fault of a child who is sexually abused. Abuse is abuse whatever the context. For a child to experience sexual attention as better than the rest of their existence, it is evidence of the failure/neglect of their carers to offer a safe, secure and nurturing environment which the child is entitled to and has a right to expect.  Sexual abuse can confuse a child who expects adults/carers to meet their needs and not abuse them. To a neglected child, sometimes any attention can feel better than none at all even if it is inappropriate/abusive. A child is dependent and vulnerable and no one should take advantage of that.  Whatever signals a confused child might give, they are not wanting sexual attention, they want to have their core needs met for a safe, secure, nurturing, validating environment and to feel unconditionally loved in a non-sexual manner.  If these needs were met the child would not be confused in the first instance!

Question 26: Having been sexually abused from eight to eighteen I am now fifty six
and realize I still have issues with stunted mental growth. How can
this be treated? I feel I am getting worse trying to function in the
world…just getting by!

 

Answer 26: I am unsure exactly what you mean by stunted mental growth, but I will assume that you are describing psychological and emotional  difficulties from the abuse that have not yet been healed. What is suggested by your question is common to survivors of CSA, maladaptive core beliefs and associated rules for living developed in childhood still causing problems in later adult years. As is often the case, survivors do their best to cope with the thoughts and emotions associated with the beliefs, but often the coping strategy does not deal with underlying maladaptive beliefs (or  lifetraps as they are called in the re-inventing your life book).

 

I think that you probably need help to identify your own maladaptive beliefs so that you can work with them and develop more adaptive beliefs and rules for living in their place. It might be worth you getting a copy of the re-inventing your life book and doing the lifetrap questionnaire  in chapter 2, to see which lifetraps, if any, you have. The book does then have specific chapters to address any lifetraps that are scored as significant for you. You can then try and work on them on your own and/or seek a trained therapist to help you make the changes.

It can be surprising how having the understanding and insight into the mechanisms that maintain your difficulties can be the start of the road to overcoming them.

Question 27: I have recently discovered that my daughter of 16 is self-harming. I

caught sight of the cuts across her stomach by accident. She assures

me that she has this under control now and that she will not do it

again. Being a survivor from childhood sexual abuse I have been there

myself and I think the thing that hurts me more than anything else is

that she has found herself in such a dark place. We have always been

close and she appears to be able to talk to me about anything,

something that I could not do with my parents. She has also discussed

thoughts that she may be bi-sexual with me. I reassured her that

thoughts and questions about sexuality, particularly in the age

bracket that she is in, are perfectly normal but there would certainly

be no issues from me or her dad if that was in fact the case. She was

not unhappy about her thoughts on this and we chatted about it quite

openly.My question is really, what, if anything should I do regarding

the self-harming? My initial thoughts were to give her time to see if

she had in fact ‘stopped’ but I have no real way of truly knowing

that so at what point can I stop worrying? She wrote me a long letter

telling me not to worry but also saying that she does not want to

discuss it and for me not to mention it to anyone as it is now in the

past…?

 

Answer 27:  I can understand your dilemma, especially being a survivor. I think a key question relates to the last line above in which your daughter says it is all in the past. I am not sure what she is saying is all in the past(the self-harm  or what caused the behaviour) , but the fact that she has cuts across her stomach indicate that whatever it is cannot be too far in the past, unless they are scars, rather than recent cuts. She has of course said that she will not do it again (self-harm).

For anyone to get to a point where they feel the need to self-harm suggests significant psychological trauma at some time in their life. Are you aware of any events/trauma in your daughter’s life that might have precipitated her self-harming behaviour? It is good that you have a close relationship with her and you appear to have handled her thoughts about bi-sexuality very well. It may be that in relation to the self-harm the best you can do is to make it clear to your daughter that you are concerned/worried about it (despite her telling you not to be in her letter!), and that you are available to talk about it when/if ever she needs to. If appropriate you could share with her that you have also been there so understand what drives the need to self-harm. You could also suggest that if she would rather speak to someone neutral, she could speak to her GP or an appropriate voluntary organisation. The key here is not to push too hard, and allow her to choose when/if she is ready to talk about any underlying issues and to whom he chooses to discuss it with.

Obviously if you thought her behaviour was putting herself at serious risk, you might want to speak to her GP yourself, but only if you have serious concerns.

As a  caring parent you understandably want to help  your daughter out if you can, and in the short term it may be that you have to watch and wait until she asks for you to become involved.

Question 28:

Hello, I have been in therapy now for 6 months and have uncovered

through therapy that I was sexual abused by my father when I was a

child, however I have had repressed my memories of my childhood until

now 30 years on, but I still do not have full memories of the abuse

just little flashbacks can that be totally normal and why do I not

find that I am angry towards my dad but I am angry with myself and

always have struggled with very low self esteem. Is it possible to get

through this pain ? I would be very grateful if you have any answers.

Many thanks

 

Answer 28: This is a difficult question to answer as there are many more questions I would like to ask to establish more background information and what kind of therapy you are having. Without this I can only make general comments regarding the various points you have raised.

I would imagine you went into therapy with some existing difficulties and the abuse memories have surfaced whilst addressing the initial presenting problem. The repression of thoughts and images associated with CSA to avoid the feelings attached to them is quite a common coping strategy. Flashbacks are also a feature of traumatic events, which tend to also involve strong emotional association. You indicate that you have had repressed childhood memories for 30yrs. Was this repression of all aspects of your childhood? If so, establishing the reason for this repression might help to gain further insight, including possible further details of any abuse that took place.

With regard to the anger, part of the therapy process is to help an individual process emotions including those associated with abuse if appropriate, and heal the guilt, shame and responsibility that survivors can be left to carry for years.It is not clear what you get angry with yourself for/about, but your therapist should be able to help you work on this. It is important that anger is processed in an adaptive manner to avoid maintaining the problem. The absence of anger towards your father may be indicative of the current stage of your understanding of any abuse perpetrated by him. This is only an hypothesis based on the information in your question.

Low self-esteem is an obvious consequence for survivors, and there are specific approaches that can help to build up a more accurate and secure sense of self that allows a more stable, day to day experience. The Melanie Fennell book, “overcoming low self-esteem” has a good structure to begin to make changes towards a healthy self-esteem.

The emotional and psychological pain associated with CSA can seem like it will never end. It can be healed with the right help to find an adaptive way of confronting and healing traumatic life events.

 

Question 29: Being a man with asperger’s syndrome, I find that my chances of

getting help are extremely slim. I constantly live with the fear that

there isn’t anyone out there that can help me, and I live with having

periodical flashbacks of when I was abused and raped by the person of whom I once called my friend.

 

Answer 29: The fact that you have Asperger’s Syndrome should not affect your access to help with problems  resulting from CSA. Although it is not my specialist area, I am aware that it can be difficult for adults to get access to the limited specialist services for those diagnosed with Asperger’s Syndrome. The trauma symptoms from the abuse you describe are something that can be addressed by mainstream mental health services, and your GP is the first port of call to discuss your needs.  If you have a diagnosis of Asperger’s, I assume that your GP is aware of this and will include this knowledge in the assessment of how best to meet your needs.   Be as assertive as you can when negotiating help, and I hope you are able to get the support you  deserve.

Question 30:

I wonder if you can help me, I saw your details on the Napac website.

Im currently having therapy due to sexual abuse i endured as a child

from my uncle. However there is one topic that is triggered by my OCD

that my therapist said would be good to get outside opinions from to

help me see rationally. When i was about 8 years old a friend of mine

(same age) would force me to play sexual games with her, which i found

quite unsettling and upsetting. From what i remember i think i them

showed these games to other friends of the same age. Im not sure the

time span of how long these games lasted, maybe a year? Now i am older

(23) i remembered these incidents amd i feel guilty and ashamed. What

if they felt abused like i did from my uncle? I feel like even though

i was only a child and the same age im scared that they might think i

abused them. I am terrified (and my therapist said this is my

irrational thoughts) but i am terrified incase these girls now

remember and go to the police about me, and say that when i was a

child i was an abuser. Thank you for listening.

 

Answer 30 :

I am pleased that you are currently in therapy so you have professional help with this distressing problem. You say that the topic is triggered by your OCD which suggests these are obsessional thoughts that you have a high level of belief in. An important element of the treatment is to help you challenge how much you believe that at 8 years of age you ‘abused ‘ your friends  rather than engaged in  games you learned from someone else. All children engage in experimental play throughout the different developmental stages. Some of this may involve innocent play of a sexual nature.  Your 8 year old friend must have received her ideas for the sexual games from someone else herself in order to engage you in them. If it was sexual behaviour inappropriate for a child of her age then it is possible she had been/was being abused by an older person.

The fact that at 8 years of age she would force you to do things against your wishes must have been distressing for you. However, you do describe what you did with your friends as play and I’m sure that is most likely how  they experienced it.  It would not be experienced by them as sexual abuse and certainly not the same as  the abuse by your uncle.  He was an adult who knew what he was doing was wrong but deliberately chose to do what he did. Children experimenting and playing between themselves is a normal part of growing up. I suspect that your friends won’t even remember most of the play that you engaged in. Do you really believe that play between 8 year olds is going to be viewed as abuse within a legal framework?

It is important that together with your therapist you work on challenging your belief that  experimenting with your childhood friends might have been abusive.  This will fit well within the framework of your therapy to address the abuse by your uncle which no doubt affects how you think about the childhood play with your friends.

 

Question 31: Hi Chris, for a start Thank You for doing this for

people…Ok…ok..um..I was abandoned by my mother when I was 5 and

then went to live with my grandparents for 2 years…in those 2 years

I was abused by uncle that lived in the same house..after this father

got remarried and then went through physical and emotional from him

and stepmother..she was extremely controlling and would lie to him

about things I had not done which usually resulted in strapping or

fingers burnt on the stove etc. I left there at 15 and went into a

relationship that wasn’t the greatest either but that was my fault

because I could not give him what he wanted…I am now 46…PTSD and

after 10 months of therapy cannot seem to go on with anything

anymore…the road is darker by the day.

 

Answer 31:

I am sorry to hear that you have had such an abusive childhood which has consequentially affected your relationships and quality of life as an adult. It is not too difficult to understand how the childhood abuse you describe will have resulted in the development of maladaptive core beliefs (rigid beliefs about yourself, the world and others). These maladaptive rigid beliefs which underpin our thought processing can cause an individual to make wrong choices and repeat unhelpful patterns of behaviour. The relationship you went into aged 15 that ‘wasn’t the greatest’, was probably due to a maladaptive core belief being activated and drawing you into a relationship that was not healthy for you. That was not your fault, but the fault of those who abandoned and abused you, when they should have given you a safe, secure and nurturing environment to grow up and thrive in. You mention PTSD, (Post-Traumatic Stress Disorder) which is very commonly diagnosed in those abused in childhood. This is a very treatable disorder, which in should be addressed in the overall treatment of childhood abuse.

 

I have mentioned before the book ‘re-inventing your life’ (see picture under Answer 10) which helps individuals via  questionnaires to identify any maladaptive core beliefs (called lifetraps in the book) they may have, with separate chapters for each significant lifetrap. It then offers  help as to how to develop more adaptive beliefs and behaviours in order to change unhelpful life patterns. From your description, I am confident that some work on any maladaptive core beliefs you may have would be helpful.

 

You do not indicate what kind of therapy you have been undertaking for the last 10 months, but if you do not feel you are making progress you should discuss it with your therapist. It is important that you have a clear idea about how the therapy is going to help you achieve your therapy goal(s), ( which should be agreed collaboratively with your therapist at the beginning of therapy) and your therapist will probably welcome an opportunity to discuss any concerns you may have.

The end of your question suggests an increasing level of depression which should urgently be discussed with your GP as well as your therapist at your next appointment. It is very important to address the depression first as it affects the ability to work other issues effectively.

Answer 31 (part 2) Since posting my answer to Q31 I have received additional information from the individual regarding her problems with medication and overdoses. My clinical experience of working therapeutically with survivors with clinically significant levels of depression is that anti-depressant and/ or other medication  can play a significant role in aiding the therapy process. Taking overdoses can sabotage the therapy, and where appropriate I usually have a contract at the beginning of any therapy with clients that they will not self harm whilst in treatment, and agree alternatives to keep them safe. Perhaps this kind of approach  might help you to be safely prescribed medication and help the therapeutic process.

 

 

Question 32:

I am at a total loss as to how to help my son…three weeks ago he

started having signs of depression, then he started talking about

being sexually abused while in my sisters house….twice. Let me be

clear…I have always hated this sister and only allowed her to

babysit him once and let him go to his cousins sleepover birthday…I

would not allow him to visit them…we all only saw them once a year

at Christmas at my moms and if we stopped in to visit my parents and

they came in as we’ll…she was to never se or watch my son…but

twice I guess I used poor judgement and now his life is shattered…he

is in grave mental distress struggling to put flashbacks and

nightmares into perspective…and in doing so he is only communicating

with my sister and his cousin…he is so angry and hateful toward

me…I am petrified of him and keep my doors and windows locked…I

jump with every sound in the house…he has hurled filthy names to me,

threatened to kill me and himself…he has been taken to emerg by us,

his former employer, the police, yet he sounds so convincing to the

emerg drs that they let him leave but had to attend the mental crisis

health unit and they put him on medication…won’t tell me what it is,

and he has a mandatory meeting with the psychiatrist sometime in

June….he keeps saying we are blocking or unblocking him, he states

he was eight months old when he was abused and he watched the same

person abuse his two year old cousin…this can’t be…it can’t…he

is so not in reality…if he calls to talk I can’t bring him back to

normality as he was…he gets so angry so now I just tell him I love

him, to take his medication, encourage him to see his dr regularly and

mental health care team, and I pray we get thru this with him…,for

him to go thru the healing process and love him more each day…as a

survivor of abuse I can’t seem to be able to help my son…I watch

this unfold like living another nightmare..I have talked to our local

police…the only way to get him Assessed In hospital is if I go to a

justice of the peace and convince him my son is in mental health

crisis and he can order him into 72hr hospital assessment…I keep

trying to convince myself that I may just have to do that to prevent

him from hurting someone or himself…dear god please give me the

strength to step up to the plate and help my son…I will be punished

for life now knowing of what happened to my child at my sisters house.

(Not In UK)

 

Answer 32:

A very distressing situation for you, as no parent wants to have to deal with the knowledge that a child of theirs has been abused. The account you give describes a complex set of dynamics in relation to yours son’s abuse and mental health problems and your own difficulties managing him and your reaction to his abuse. You don’t mention his age so I am unsure as to what developmental stage he might be at. It is important that you do not blame yourself for what happened whilst he was with your sister.  She has the responsibility for any abuse that took place whilst your son was with her. In allowing your son to spend that time with your sister, you had every right to expect that he would be safe. If his mental health problems are a consequence of abuse whilst he was with her then she is also responsible for your distress and problems you now have with your son. It would appear that you are doing the best you can to support your son, who is venting his anger at you, probably the safest target he has.

The severity of your sons’ problems indicates it is really important that appropriate professionals are involved in his management, treatment and care. You can continue to encourage him to remain engaged with them which is the right thing. It is also very important that you look after and protect yourself. If your son is a danger or risk to himself and/or others it is essential that you do whatever is necessary to ensure that all steps possible are taken to protect both him and others. Whilst it might  be a difficult decision to make, if the use of mental health legislation to ensure someone is kept in a safe place and assessed for appropriate treatment is the only option available, then it should be used and in the longer term it can produce the best outcome. The local mental health team would be the first port of call for any assessment under the Mental Health Act.

So the best way to help your son at present is to encourage and support him in engagement with the professionals involved, and when at a future date he is in a more emotionally stable place perhaps some healing in your relationship with him can begin.

 

Question 33: How can I overcome my need for everything to be perfect… the problem

is even when everything is done to the best of my ability, I will find

the one thing out of many that wasn’t quite right and mentally beat

myself up about it. Where does my need for this come from, does it

stem from being abused? People can praise me but the negative

committee meeting inside my head have a whole other agenda! Kate has

recommended the book ‘Re-inventing your Life’

 

Answer 33: Thank you for asking this question as it is a very good example of a problem that affects many people and not just those who have been abused. Perfectionism or Unrelenting Standards lifetrap as it is described in Re-inventing your life, is a very destructive force to have to manage in your life.  Feeling the need to achieve 100% + in everything you do is exhausting both physically and mentally as it is an impossible goal to achieve. I call it the greasy pole, as just as you think you have made the top of the pole you slide back down again because you decide there was something additional that could have made it even better (100%+). The negative committee in your head is indicative of a lifetrap that accepts criticism without question and dismisses praise or achievement without even considering its validity.

 

It may well be that as a survivor of CSA that this need for perfection is a response to another lifetrap such as defectiveness or failure. So the thinking could be along the lines: “if I am perfect then I will be worthy of love.” Or “if I achieve 100% at everything I do then I will not have failed.” The problem with all these lifetraps is that the individual’s coping response to them, whilst it appears effective at the time in avoiding or reducing strong emotions attached to the lifetraps, it does not address what the underlying issues of it are. As a result nothing changes and the individual has to continually strive for 100% in what feels like a never ending cycle. The answer is to identify the lifetrap(s) that are driving the behaviour, and work to change it or them if more than one. That is what the Re-inventing your life book was written for, as a self- help manual to guide individuals towards breaking the unhelpful patterns of behaviour that serve to maintain lifetraps.

 

The book has a questionnaire in chapter 2 which helps you to identify any lifetraps you may have and then individual chapters for each lifetrap you may need to work on. It may be that you can do much of the work on your own, but might find some of the suggested interventions will be more effective if helped by a skilled Therapist. Getting to a point where you can accept the “good enough” principle rather than the 100%+ approach will make each day a whole lot easier to manage!

Question 34: I don’t know if its ok to email and ask you something but I will

anyway.Thing is I’ve got a really poor memory of some of my childhood. Can I

just say how I keep feeling- well it’s like I’m stuck. Like deep inside

I feel like a small child that’s hurting and got no voice and it

making me feel like i want to cry but cant.  It’s such a deep feeling

(don’t know how to describe/say what i mean )but I don’t know why exactly

or if this means I’m mad. I’ve worked through some things from my

teenage years which has always been in my mind but tried not to think

about. it kept coming into my mind all the time with pictures and

things. So had to deal with it. That has settled right down but seem

to get to this point all the time where I’m just stuck I don’t know why

I can’t go any further back in my memory. If any of

that makes sense without going into detail. I just don’t know how to

get rid of keep feeling like that- do u?

 

Answer 34: I have a lot of sympathy for the difficulties you outline. You describe feeling stuck in relation to a damaged inner child that cannot express itself. The deep feelings associated with what you describe do not mean you are mad. The fact that you have worked through some issues from your teenage years indicates that you are been able to confront issues you have previous not wanted to. I can only hypothesise what might be going on with the lack of or poor memory of some of your childhood. Your description if a “small child that’s hurting and got no voice” suggests the need for therapeutic intervention to enable you to work with the hurt child and articulate its needs.

Usually the most effective tool that I have used has been imagery where techniques are engaged which enable the client to connect with the needy/abused child and help to heal the pain and meet the unmet needs.

This can be a very powerful process, which requires a skilled therapist who has the necessary experience to be able to safely work with the client.  Imagery can be very helpful in opening up powerful memories from life events buried away or avoided, and then be used to heal. It is important that the therapist does not lead or suggest memories to the client, rather they are allowed to float up of their own accord. There are other approaches that can be used, and much will depend on the core therapeutic model of the therapist.

 

 

Question 35: Hello I have been in counselling now for other 8 months and am going

through the process of remembering my childhood abuse with my

therapist after having no childhood memory at all I am starting to

remember and getting flashbacks. I have now thought very hard and

have come to a decision to cut my ties with my father and do don’t want

him in my life no more; however would you have any advice of how I go

about this as I am worried about his response and what he could be

capable of doing so need to protect myself and my kids first but

don’t know what to do. If you could please give me any help or advice on

this I will be very grateful. Many thanks

 

Answer 35: I read your question and immediately thought that this is an issue that your therapist should be addressing with you. If you have any concerns about your safety and that of your children you should discuss it with the police and your local safeguarding team. I would have thought that the local social services should be able to help and advise you. It is essential that you have your safety plan in place before any potential conflict or risk with your father. In the past, with the help of other agencies, I have helped clients in dangerous domestic situations to remove or minimise risk to themselves and others.

How you tell your father you want no further contact is something that you and your therapist should discuss. There are various options as to what medium you use to communicate your decision to him, the important thing is to choose the one that is safest and most acceptable to you. Remember you need your safety plan in place first!!

 

 

Question 36: Do you think doing kick-boxing classes will help me learn
psychcological boundaries too?
Atm when i walk anywhere near someone, i feel like they are going to
punch me…the closer they get, the more effort it takes me to cope.
Ive done well coping like this for 38 years without reacting.
I was wondering….in a controlled environment where my physical
boundaries are getting crossed, but not in a bad way…will this also
help with that fear that i feel everywhere i walk?
Just wondered what you thought?
I guess ill only find out for real if/when i start…i guess im just
building myself up for it. The more benefits i think from putting
myself in such a challenging situation, the better.

 

Answer 36:  My first thought on reading this was to wonder what it is that has created the fear experienced wherever you walk and of being punched. If you have been managing this fear for 38 years there is clearly some underlying mechanism that is maintaining the problem. If you know where it comes from (possibly  traumatic life event(s)) then it would be helpful in the long term to resolve the underlying issues to reduce  the need to learn a self-defence skill to manage day to day living. That is not to say that kick-boxing exercises would not be good for you both physically and mentally anyway, but unresolved trauma from the past needs addressing if you want it healed rather than managed.

 

Question 37:
I saw my dr today for a meds review and a few other issues, my meds
were meant to be changed from mirtazapine to an anti psychotic ie
olanzapine. My dr stated she is unsure whether to prescribe them as
she is out of her comfort zone with these meds and because I have been
in and out of the mental health system since I was 7 she thinks I have
been let down by the system. On a stranger note she says she is not
sure if I am mentally disturbed or emotionally damaged due to the
trauma I have suffered in my life. please can someone explain the
difference to me as I am aware I am emotionally challenged and very
mentally unstable.

 

Answer 37: I am unable to comment on medication as I am not qualified to do so. I think my observation on your doctors’ comments about prescribing particular medication is that if she is not able to make an informed decision she should refer you on to a specialist such as a psychiatrist who can help her in the process. I don’t understand the “mentally disturbed or emotionally damaged” statement as you quite rightly say you experience both emotional and psychological problems.  I  think that the two issues go  together, psychological  disturbance will inevitably cause emotional disturbance which both need addressing.  It may well be that you have been let down by the mental health system in the past, but getting the correct medication prescribed and being referred for appropriate psychological support can attempt to remedy any past failings of the system.

 

 

Question 38:

Just wondering what your thoughts are on my having hypnotherapy

treatment for my childhood abuse issues?

 

Answer 38:  I am not aware of any research evidence for the effectiveness of hypnotherapy for the treatment of childhood abuse. Whilst there is some research on the efficacy of hypnotherapy alone and paired with other treatments such as CBT for some milder illness such as phobias, it is important not to assume that it will therefore be effective for other more complex problems.  The National institute for health and Clinical Excellence (NICE) website has listed treatment interventions that it has assessed as having a sufficient evidence base for it to be deemed clinically effective for particular mental health disorders.

I have stated before it is important to be sure that any therapy you might engage in is being offered by a suitably qualified and experienced clinician, and that there is some evidence that a particular approach works.

Question 39:

 I’m really struggling. I’m one of the lucky ones in that my abuser was convicted & went to prison for a 9 year term.

He is now free & lives 5miles away & is on the sex offenders register for life. I have never seen him since Court.

My struggle is anger. I’m so angry at everyone & everything. I think

I’ve realised that I’m angry because I am not loved. My mum never

showed me love as a child. My grandparents did but they are now dead.

My early relationships before everything bubbled over, were damaged by

me, not understanding my distrust & possessiveness. I lost their love.

I have siblings but don’t feel loved by them. Relationships since

reporting the abuse have been unhealthy, me choosing married men twice

(I’m not proud) & of course they promised me but never chose me. A guy

who cheated in me too. I’ve spent many years single, mainly because I

don’t feel I belong, I have quite low self esteem, & due to living

alone & working alone at home I’m very secluded. My ‘friends’ don’t

really care for me. I’m excluded at weekends & never invited to

events. I fight to believe this is not because I’m a bad person. I

feel easily overwhelmed & feel all my energy goes into coping &

working enough to earn enough money to pay my bills. My

responsibilities cause me huge stress. I have no help at all. I

honestly believe if I died it would be days if not weeks before I was

found. I feel forgotten, insignificant & this results in anger. When I

identified little me by drawing I was in my school pinafore, age 5.

Before everything terrible happened to me. A time when I lived with my

grandparents & a time when I remember love & have good memories. I

can’t express my anger, it never shifts. I lose friends if I try to

explain. I don’t feel interested in socialising, I wish for everything

to just be ok. To have a loving partner & to be happy together. To

also be able to rest, I constantly feel exhausted as I can never stop

due to my responsibilities, home, work, pets. I’m also angry because

I’m too old to have children so I feel another thing has been taken

from me. I feel I have no voice. I’m looking in on the world through

thickened glass. It doesn’t seem to matter how hard I try to pick

myself up & try a few social things the result is the same. This life

feels like an endless punishment. Another weekend has passed &

absolutely nobody has contacted me. I’m so alone. I panic all the time

about life passing & me getting older makes me feel ill never meet a

partner. I’m scared of being old & alone. I’ve had lots of therapy

over the last 20 years. The one therapist that helped me has moved

away so I can no longer see him. I have seen other therapists but I

feel their skill set is not enough for me. All that results is I get

more angry. They have no structure & at the end if each session I feel

I have not achieved anything. I feel they have recited some basic text

to me, which I already know. Every now & then I plan how to opt out

but something within me stops me actually doing it. I think the main

thing that stops me whether I’m brave enough to do it, whether I’d

screw it up & end up disabled, & my pets I’d leave behind. If you can

offer me any help I would be very grateful.

 

Answer 39:

It is clear that you are suffering from a significant level of depression which needs addressing immediately. I would advise you to see your GP as soon as you are able to discuss what help can be offered, both in terms of medication and other support. Even if you are already taking medication you may need a different dose or a change of type of medication which could be assessed by either your GP or a psychiatrist.

You describe a lot of anger which if not processed appropriately will remain internalised and contribute to your depression. In your question I can see many of the cognitive distortions (thinking errors) common in depression. Your reported sense of hopelessness about your situation now and in the future is also indicative of common themes of depression. Depression responds well to CBT which you may or may not have had in the past. It is an evidence based therapy recommended by NICE. In order to address your deeper underlying problems the depression needs treating first as it distorts how you process information and it can inhibit change.

 

You also mention a male therapist who helped you. Do you know what kind of therapy he offered and what was it about the therapy he offered that made it helpful to you? It should be possible to find another therapist who offers the same model of therapy if you know what it was. You make an important point about having a belief that your therapist is qualified and experienced enough to help you.   It is not clear what approach the unhelpful therapists were using with you, but the absence of structure and lack of any obvious benefit from sessions suggests that whatever they were offering was the wrong one for you. I would suggest that when seeing your GP you discuss your depression and help to find effective psychological support.

 

If you are looking for private therapy then there is some guidance on the TTW website, click on the” other resources” button and then scroll down to Therapy/ counselling. From the details you have given about your history, I would think you need to engage in some longer term therapy (i.e. not brief/short term) with an experienced therapist who has previously treated clients with  complex needs such as yours.

The starting point is tackling the depression so get to see your GP as soon as you can.

 

Question  40:

Today I decided to drive past my grandparents old house where the
abuse started. My Therapist and a friend said they would go with me. I
went alone, I am use to doing things alone. Truth, I did not think it
would be that bad. Thought it would be easy but when I go to work, I
started to remember things and felt like I was trying not to break
down. Is that normal? I am scared to drive by their again. I do not
know what to do and I really hate this feeling.

Answer 40: As you mention that your therapist was willing to accompany you on the journey, I assume that this decision to drive past your grandparents’ home was agreed as part of your treatment/therapy?  I would hope that this is the case, and if so, your therapist should be debriefing you about the outcome and working with your response therapeutically. With any exposure like this it is vital that there is a clear therapeutic rationale for undertaking it, and appropriate preparation beforehand.  The fact that you have had a significant emotional response to the experience and it triggered new memories suggests that there is significant work to do before attempting a similar event again.  This should be discussed in detail with your therapist. You indicate that you are used to doing things alone, so it may be that as part of the therapy you  try something different and see what happens when you have someone to help you in difficult or challenging situations.

 

Question 41: 

I was abused about 40 years ago. Only once but I am now thinking that

it has had an adverse effect on my life. Is my GP a good starting

point for help? And do I need to give details to her?

 

Answer 41:

Being abused whether once or on multiple occasions will have an effect on the individual which may manifest itself around the time of the abuse or later in life when links are made between current difficulties and the abuse. Your GP is a good starting point to seek help, but you do not necessarily have to give detail of the abuse episode to her. Letting her know that you have been abused in general terms will allow a discussion about the help your GP can make available to you by referral to an appropriate service. The resources page on the TTW website has a number of organisations whom you could contact if you wanted to discuss it over the phone with someone in the first instance. I wish you well in getting the help you need.

Question 42:

I am worried about my friend. He was abused as a child by a cousin.

He has been depressed over the last few months and deals with it by

throwing himself into his work to the point where he can’t switch off

and have fun. We persuaded him to see his GP who prescribed medication

but he won’t take it. He gets angry about his situation and seems to

have given up hope of being happy. I know its his choice but its hard

to see him like this. I think counselling might help but he says he

can’t afford it because his money only covers bills. He can be very

hurtful with words when he is really low so its hard to be around him

but I don’t feel I can walk away. I was abused when I was a child so I

know how damaging it is. Any ideas how I can help? Thank you.

Answer 42: I fully understand your frustration with your friends’ situation, and not knowing how best to help. This individual appears to be using activity/keeping busy as a coping strategy which is not adaptive as it does not address the underlying problems. Often individuals with depression lose insight as their thought processes become increasingly distorted by the illness.

Your question raises a very common dilemma for many people, that of wanting to help someone in need but having to accept that there may limited options open to us. In this particular situation it would appear that he has agreed with the GP that medication is needed, but then decides not to take it. It is his choice what options he chooses or rejects to address his problems, but the options are often limited, so if he wants change he will need to try something different to what he is doing currently which is not working.

 

From the information you have given it would appear that he is clinically depressed and therefore would benefit from a course of medication and some Cognitive-behavioural Therapy (CBT). Across the country there are now local NHS services (IAPT – improving access to psychological therapy) offering short term CBT where there should not be too long a waiting list.( I know there is a problem with wait lists for longer  term therapy)  Depression responds well to CBT and can be helped if medication is taken as well. You clearly care about this individual so perhaps encouraging them to discuss with their GP their reasons for not wanting to take medication and ask about NHS therapy is the best you can do. It is important that you do not allow this person to abuse you with their anger, clear limits as to what you find acceptable need to be communicated.

Ultimately he is responsible for the choices he makes regarding the help he will accept, and has to live with the consequences of those choices. It can be difficult to watch someone struggling, but you cannot force them to do what they don’t want to do, even though might be best for them in the long run!!

 

 

Question 43:

How do I get over the feeling of never feeling like I deserve to be happy or that I deserve anything good to happen to me?

Answer 43: The significant word you have used twice is feeling. I say that because there is a mantra I use with some clients that says ‘feelings are not facts’. This is very important in the context of CSA, because survivors have often been left with the feeling/belief that they are not deserving as a consequence of the early life experiences. The fact is that everyone deserves to have some happiness in their life, especially if they have suffered in their childhood.

These ‘feelings of feeling undeserving’ are usually indicative of schema/lifetrap driven emotional responses to life events.  If you look at the reinventing your life book and complete the questionnaire(s), you will establish which lifetraps may be affecting your ability to experience life in a more fulfilling manner. You will probably need to do some work on nurturing the damaged inner child who did not get her needs met when she had a right to expect they would be, as part of the process of developing more adaptive beliefs and behaviours to counter the lifetraps.

Learning to look after, nurture and be kind to ourselves is essential to our healthy day to living. In order to get to the stage where we are able to do this may involve seeking some professional help if we are unable to do it on our own.

Question 44:

I hear lots of talk about ‘forgiveness’ but the only person I want to

forgive in terms of the abuse I suffered is to forgive myself… how

can I work on that, how do I do that? thanks

 

Answer 44: I am pleased that want to ‘forgive’ yourself for the abuse you suffered. It does suggest that inherent in the desire to forgive, is a sense of guilt/blame for the abuse. What is it that needs forgiving when you were not responsible? The abuser is of course solely responsible for the abuse, and whether or not they can be forgiven is a very different matter.

 

Like the previous question, this appears to be very much about working with the abused inner child, nurturing her and meeting her unmet needs from childhood. In my clinical practice   I use imagery rescripting to help clients connect with the inner child and change the way the inner child views, and feels about, the themselves and the abuse. CSA can leave a child with a very damaged and confused sense of themselves, the world about them and other people, which they carry into adulthood. Healing the inner child can help to change the beliefs and behaviours that can prevent us having adaptive responses to life events and relationships as an adult. There is no shortcut to this process, but you can start on this yourself with books such as reinventing your life, which is specifically written to facilitate the change needed.

 

Question 45:

Hi, I am told no specific help exists for PTSD …is this correct? Isthere a good book you could recommend even?

Answer 45: I don’t know who told you that no help is available for PTSD but that is simply not true! PTSD is a very treatable illness, with CBT having a very good evidence base for helping to treat trauma symptoms. NICE (National Institute for health and care excellence) have indicated that CBT is the treatment of choice for PTSD too. There should be therapy services to treat PTSD in most if not all areas of the country available through the NHS primary care service. Usually this is offered on a basis of 6-8 sessions using evidence based protocols, with an accredited therapist. Your GP should be able to point you in the right direction for this service in your area. As far as a self-help book is concerned, overcoming traumatic stress by Claudia Herbert & Ann Wetmore is a CBT based book that should help to understand and confront the illness. It is likely that some help from a therapist will be needed if the PTSD has been there for more than 6 months.

Question 46: I was sexually abuse by my grandfather from age 9 -13. Five years on I

feel I have overcome my problems such as depression & suicidal

thoughts. I still have mild social anxiety & find it hard to trust

people, especially men. I never went to a therapist, but do you think

I should now? I’m worried for the future, eg. I don’t want my past to

affect me when i’m sexually active in a relationship. I’m not sure how

I would react in that situation.

 

Answer 46: It appears you have done well in managing your depression on your own, but it is not surprising that you are still experiencing other difficulties associated with the abuse. The concerns you express about trust and future relationships are entirely understandable. The vast majority of survivors of CSA would benefit from therapeutically working through the abuse to prevent it from causing the kind of on-going issues you describe. As children we find the best way of coping with the abuse which works to some extent, but often those same coping strategies are not adaptive as an adult. This is where therapy can be of help in establishing more adaptive coping behaviours as part of the overall therapy process.

As always it is important to find the right therapist for you, who is appropriately qualified/accredited and experienced in helping individuals with problems such as yours.

 

Question 47 : Is it normal to still be messed up as an adult? I feel constantly judged and in the wrong even now

 

Answer 47 : Assuming you are a survivor of CSA, it is the case that the effects of the abuse can trouble you at any time of your  life, especially if there are unresolved issues from the experience. Abuse is traumatic, and at any time powerful emotions/memories/images can be activated by triggers as many survivors will testify.  Feeling judged and in the wrong is indicative of poor or low self-esteem, and perhaps even a defectiveness lifetrap. (as described in  “reinventing your life”)  I have said before on this Q&A page that feeling something  does not mean it is true! We need to look at the evidence for what we are telling ourselves rather than accepting our emotional response as confirmation of fact.  It is important that you have a good self-esteem in order to be able to assert yourself and believe you are as good a human being as everyone else.  Perhaps the  overcoming low self-esteem book would be a good starting point.

 

Question 48 :

hi chris, ,how can i get myself to believe that everyone isn’t going to hurt little Jenna (name changed to protect identity)i am always on guard expecting everyone to hurt me, it causes me problems where i always see the situation wrongly then it becomes destructive in my head which jeopardises everything then,, I do not believe i am likeable and loveable, which is how i end up seeing the worst of every situation. thank you.

Answer 48: This question is a very good one as it again demonstrates how the effects of lifetraps, formed in childhood continue to cause problems in adulthood. Fear of everyone going to hurt you (Mistrust/Abuse lifetrap) believing you are unlikeable/unloveable (defectiveness/Shame lifetrap) both come under the domain of disconnection and rejection. Without a more detailed history I can only hypothesise that you may well have some other lifetraps connected to your unmet core needs in childhood.

It is important to understand how these lifetraps were established in childhood. Little Jenna needs to be helped to get her needs met so that the lifetraps and the strong emotions associated with them are neutralised.  This involves cognitive and behavioural intervention, including some imagery and re-scripting which is a very powerful tool for healing damage to the little inner child. The re-inventing your life book addresses the strategies I have indicated, but I would say that from my clinical experience that the imagery and re-scripting almost certainly requires a suitably experienced professional to help manage and guide the process. Of course little Jenna is likeable  and loveable, but she needs help to believe this, just as she needs help to understand that whilst what she learnt in childhood about coping with abuse or potential abuse may have worked then, it is not adaptive in adulthood. As a child it may well have seemed that everyone was a potential threat, especially if those responsible for your care did not provide the safe and secure environment you had a right to expect. In adulthood, most people do not pose a threat, but because of the lifetraps it feels like you need to use the same coping strategies you used as a child, which as you describe, causes problems and misreading of situations. There is no quick fix here, but change can happen with the right approach such as I have outlined.

 Question 49: I just wondered if it was normal to not report CSA because you don’t want your parents to be subjected to abuse from other family members..I want to report it but don’t want them getting hurt or ill i told my mum about it today. I just dont know what the right thing to do is im just stuck between justice and family.Answer 49: The most important person in your dilemma is YOU. What do you want and need for you to heal. It is understandable that you have a desire to protect your parents from any fallout from any formal report of CSA. I am unaware of the details of the abuse so I am not sure who is responsible. The important part of your question is “I want to report it but..” , which suggests you  have a need to do what is right for you. You are not responsible for the consequences of reporting the abuse, the abuser is. As such it is absolutely right that you put your needs first and for others to deal with whatever the outcome is for them. As a survivor it is sometimes easier to subjugate your own needs, but part of the healing process is putting them at the top of the list!Question 50: I am a survivor of CSA. I have been married 15 years.My husband knows about the CSA but does not talk about it.He has always needed to plan in life, write lists and feel in control.In hindsight, and with the help of on-going therapy, I can see thatthis need to control has been grinding me down.He needs to know my plans for the day, who I’m seeing, who they are,what time I’ll be back.. only for me to have to recount what I havedone all over again at the end of the day. He can be quitecondescending, belittling things I do or re-doing them himself becauseI haven’t done it right. He controls the finances of the house so ifI need cash I have to ask him and generally explain why I need it; Ifind this particularly hard as we have 2 children who always seem toneed money for something. All of this I felt I was on top of, copingwith…..My real difficulties are at night when he wants sex. I strugglepredominantly because of the things he says:’Look what you’ve done..”You’ve got to sort this out’ ”You deserve to get ……’….They all leave me as my vulnerable child. I feel that this isalmost a punishment for standing up to him earlier in the day… hisway of regaining control but I could be wrong. I don’t participateand now I don’t talk – I have said ‘no’ in the past and I havetold him I don’t like the things he does but it hasn’t stopped ithappening. He’s not violent. Some of the things that he does atnight do hurt but he doesn’t hit me or anything. My real question ishow do I get the adult part of me involved at those times? I amleaving ‘my child’ to sort things out but I actually don’t know how to

change things…? As a family I think we work well together and I feel

if I didn’t have the history of the CSA I would be able to cope with

this part of the relationship too…?

 

Answer 50 : I am sorry that you are having to  deal with such difficult circumstances in your relationship with your husband. It is significant that your husband knows about your CSA but not only chooses not to talk about it, but also treats you the way he does.

I have to be clear that if your husband is forcing you to do things you don’t want to do then it is abuse. If anyone is forced to have sex despite explicitly stating they do not want to, it is rape –even in a marriage. It’s not surprising you find yourself in the vulnerable child mode when your husband is not treating you as an equal adult, forcing you to be dependent on him just like a child which is emotionally abusive. As you quite rightly say, it is difficult for the vulnerable child to sort out adult issues. You mention you are in on-going therapy. It would seem to me that a priority in the therapy is to help the healthy adult part of you to grow and be able to assert yourself and your rights. It is not acceptable for your husband to belittle and humiliate you and not respect you. I am not sure what model of therapy you are engaged in,  but an appropriately qualified and experienced therapist should be able to help you systematically through the change process and how you manage your relationship. From your question there appears to still be a need for some work on the inner child also, and to address the lifetraps resulting from the CSA. The last sentence of your question is very pertinent, but as you are a survivor of CSA you need help to sort out what is currently a very unhealthy and abusive relationship. Your therapist is the person that should be able  to help in the first instance.

 

Question 51:

My therapist said some time back that she isn’t qualified to explore

and work on my childhood sexual abuse with me, for a time we worked on

other things like coping skills. But now she is saying she will do

‘inner child work with me’… I’m not fully comfortable with this…

if she cannot work through my abuse with me, is she able to safely do

this inner child work with me? Thanks for your help.

 

Answer 51: This question rang alarm bells when I read it. All therapists have a duty to practice within their competency, that is, only offer therapy for which they are adequately trained or qualified. All therapists should be signed up to a standard of conduct and  code of ethics as part of belonging to a professional body. This includes knowing when you need to refer on to more experienced or specialist therapist/service. The fact that your therapist has told you that she is not qualified to work on your childhood abuse would suggest that is still in training or does not have the relevant experience to competently work with the childhood abuse. Inner child work  (no matter which therapeutic model you are working with) will necessarily involve working with the childhood abuse. This is a very skilled process which if done incorrectly can re-traumatise the client. I would suggest you raise and discuss your concerns with your therapist. Trust and confidence in your therapist is a very important part of the therapy process, so you need to have these before proceeding further.  Remember, it is your therapy and your choice and decision.

Question 52: I was wondering if you could advise me on an issue with dissociation?

To give you some background. I am currently dealing with recovered

memories and flashbacks of various traumatic events in my childhood.

Between the ages of 3-11 I was sexually abused by 3 men in or closely

linked to my family and have been emotionally abused by another family

member throughout my life. I was also attacked by a stranger at the

age of 8 and physically and sexually abused. Many of these memories I

repressed and I am going currently going through the difficult process

of dealing with this abusive history. I have good support from my GP

and I am in therapy, which is difficult but I see as a very necessary

part of my recovery.

 

I am aware that throughout my abuse I have used dissociation to

survive the traumas (amongst other things) and on a lower level

throughout my life in coping. It is over the last 18 months I have

really started to look at all this and over the last few months I have

been having more and more flashbacks and memories (including body

memories and feeling like I am back in the moment of the abuse). I

realise this is all linked to PTSD and on the whole I can rationalise

most if what is happening to me, not necessarily in the moment itself,

but through what I know on the issues I realise when I am not

mid-flashback that this is all a ‘normal’ part of recovery.

 

However, last night I woke up in the night and for a little while

(maybe only a few minutes at most) where I seemed to have a sort of

temporary amnesia. I couldn’t remember who I was or where I was. As my

memory came back one of the first things I thought of was of my

abusive history and I got a sinking feeling.

 

The only thing I can link it to for yesterday was that I told my

friend about a new, particularly hard memory I had a few days ago. It

takes quite a lot for me to go into these things with anyone. So maybe

that triggered it. A few years ago, not long before I first told

someone about the attack in my childhood (I had had the first

flashbacks a few months previously) I had a similar moment when on a

bus where I didn’t know where I was or what I was doing. I put it down

to stress at the time. It felt similar to this but very different as I

also did not know who I was this time.

 

My question is, is this ‘normal’ for what I am going through and

should I expect for it to happen again? Although I realise it is

probably some form of dissociation and is a coping strategy for me

somehow, it has shaken me a little.

 

Answer 52:  Thank you for sharing the very difficult problems you are currently confronting. You demonstrate a good insight , and articulate how complex it can be to understand how the mind and body works when confronting repressed trauma. A simple answer is to say yes, it is a normal part of the process that when abusive memories come to the surface to experience the difficulties you describe. I am not surprised you are somewhat shaken by the experience.

The connection you make between the disclosure to your friend and the night time episode would make sense. The brain does a lot of “housework” whilst we are asleep, including processing unfinished business from the waking hours. It is quite possible therefore that this is what woke you in the night, when it can be quite disorientating in the dark when we are on the cusp of being asleep and being awake. The fact that you are in therapy and working on the abuse increases the likelihood of flashbacks/memories being triggered.

Dissociation is a coping strategy that enables a detachment from the here and now to protect against unwanted images/thoughts/emotions. Survivors of abuse have often described to me how dissociating during the abuse was the coping strategy they found the most effective survival tool in the situation.  It is not uncommon to become disorientated and experience difficulty grounding yourself in the here and now after dissociating.  I can recall a client I worked with who dissociated in the therapy session and took quite some time to be able to take in where she was and what was going on when trying to ground herself. “Safe place” images and grounding techniques can help to manage these kind of episodes whilst in therapy, with the expectation that as the therapy progresses the occurrence of them will diminish over time. It is not possible to predict whether you will have a similar episode again, so it is important to discuss with your therapist strategies and coping skills in preparation should another episode occur.

Question 53: I am finding it very difficult to overcome the past and someone said to me people choose to live in the past and need to snap out of it, that made me feel bad so does that make me weak.

Answer 53: It does make me quite angry when I hear of survivors being advised to ‘snap out of it’ as though they would choose to make their own lives a daily challenge. Whoever said this to you can have no idea what it is like to live and cope with childhood/past trauma. There is no choice about how abuse will affect you at the time, or throughout your life. We all carry around with us our past life experiences, good, bad and everything in between.

For those fortunate enough to have had a healthy childhood free from abuse, there will be  no triggers/flashbacks/memories/pictures/smells etc. like those that can permeate and challenge the daily life of a survivor. All I can say is let these individuals walk in the shoes of a survivor for a week and see whether they would still use such punitive language.

Throughout my professional career I have challenged the use of the strong/weak dichotomy, as it is unhelpful and just wrong. A victim and survivor will have spent much of their life trying to cope with the consequences of the abuse, which can be very physically and emotionally demanding. Far from being weak, a survivor is demonstrating how robust they are by managing their daily life as well as coping as a survivor. You should give yourself credit for surviving as you have. You are not living in the past, you are living with your past which is something that the individual who upset you does not understand.

Question 54:

Hi Chris, how do you carry on a friendship with a fellow survivor when you only seem to trigger each other? One is struggling with therapy and the other is struggling with therapy but also self harm. I’m the self harmer but she often doesn’t answer my messages. Is it because she is having a bad time or because i’ve done really bad. Do people stop caring if you hurt yourself? I’ve done it for over 30 years. Guess I am not really worthy of anyones real care?

Answer 54: You describe a difficult dynamic in the relationship with your friend, as you are both trying to manage as survivors, whilst having a supportive friendship. You are both in therapy which should be offering you both some support and focusing on underlying  issues. I would expect that you are addressing your self-harm behaviour in your therapy, as learning more adaptive emotion regulation behaviours should be a priority before any other issues. The last two questions you pose are indicative of possible underlying lifetraps such as defectiveness and emotional deprivation. Self-harm by an individual can cause heightened levels of anxiety in those who care about them, as they often feel powerless or unable to help. Perhaps your fellow survivor has such feelings and does not know how best to, or whether she can help you? You mention that you trigger each other so perhaps she does not answer some messages as her way of protecting you both?  No doubt your friend has episodes when she is finding coping more challenging than other times, which may influence her ability to interact with you or anyone else.  Self-harming does not make you bad or unworthy of care from others. It is a means of coping with the psychological distress you experience as a survivor. Unfortunately it is not an adaptive coping strategy in the long term as it does not deal with the causes of the distress. As indicated earlier, those who care and worry about you may not know an appropriate way to help or care for you, so having professional help to find  more adaptive coping behaviours and deal with the underlying problems is important. Perhaps you can negotiate with your fellow survivor a mutually supportive type of contact, with content that minimises the risk of triggering each other.

Question 55: I survived several years of violence and sexual abuse from early childhood, followed by a couple of violent relationships as an adult.

I’ve had a number of courses of therapy over the years, usually long

after the latest crisis has passed (given the nature of the waiting

list system), but somehow I’ve come through and even thrived to some

extent.

The problem is that I just haven’t been able to talk to anyone about

my most intimate feelings about sex and relationships – not with the

therapists, “safe” family members, friends or anyone. The thought of

doing this is intensely unbearable.

I have had various relationships and flirtations in the past,

including the violent relationships mentioned above, but with a few

exceptions I often found myself losing sight of my identity and

becoming obsessive. I think my behaviour could best be described as

fear-avoidance attachment – although I don’t like labels, I think this

best describes the problems I had in these relationships, although

things were starting to improve.

 

I used to hate the way being in a relationship made me feel, and when

the last one ended about 12 or so years ago, I decided not to enter

into any further relationships until I’d gained more confidence and

maturity.

The weeks turned into months, which turned into years, and in the

meantime I’ve grown older and feel increasingly less attractive. I’ve

had crushes along the way, but have been consumed by anxiety each time

and unable to talk about it. They’ve always petered out eventually,

and I’ve been able to get on with my life without making too much of a

fool of myself.

Each time I’ve tried to learn something from the experience, and on

one level I’ve even enjoyed how I’ve felt. However I’ve always been

too anxious and embarrassed to act on the feelings, and very often the

crush has been unsuitable anyway. Most of the time I just feel happier

- and safer – on my own.

Anyway, to sum it up, for many years now I’ve successfully managed to

avoid dealing with this problem in a substantial way. However I’ve

recently started working closely with someone I’ve developed feelings

for, and this time I just can’t avoid it. A substantial part of my job

depends on a substantial part of his job, and as he’s new he’s been

relying on me very heavily.

 

In fact people have noticed that he is always at my desk, which I find

excruciating as I did joke at first that I fancied him. It feels like

all eyes are on me now, and I’m completely stressed out about it. At

the same time, I’m also stressed out with various work-related issues,

including the aftermath of a dispute with management that occurred

earlier this year.

I just feel completely overwhelmed by this situation, and at the same

time my attraction to this man – as with all my previous relationships

and infatuations – acts as a very strong trigger to my memories of the

abuse. In fact it acts as a trigger to a whole raft of complicated

feelings and emotions, and when I’m alone I spend much of my time in

tears. I feel completely backed into a corner with nowhere to turn,

and have become quite depressed.

 

I can’t tell this man how I feel, because the way I feel is basically

that I’m strongly drawn to him but completely freaked out about it at

the same time because I’ve been so badly abused by men in the past.

Also, given that we work together so closely, and given that I don’t

really know him that well, it could all blow up in my face in a very

public way.

However, on a positive note, I think I’m finally ready to start

talking about this situation – in fact I think I need to this time,

because bottling this up any longer could send me over the edge. I’ve

made an appointment with the doctor to see what she can offer

(anti-depressants as usual and another waiting list for therapy,

probably), but have also decided to write to you – primarily to get

this all down on paper for the first time, but also to hear your

suggestions, as I would value your advice.

I also really wanted to share this story with This Tangled Web, as I’m

sure there must be others out there who feel the same as me and could

be helped by this. Also, I can’t find any guidance on forming and

maintaining relationships specifically for survivors of abuse, and

wondered if you knew of anything that could help.

 

After years of therapy, this is the one thing that I haven’t really

made any progress with, as I just can’t talk about it. Whenever it’s

come up in therapy, I’ve just glossed over it, because talking about

sex and relationships in any meaningful way is just too personal and

uncomfortable. A therapist did try and push me into it once, and I

completely clammed up! She did apologise.

Can you please help?

 

Answer55: Thank you for sharing so much detail of the difficult issues you are struggling with. Well done for all the hard work you have already done to make sense of your difficulties, which has brought you some important insights that are evident in your question. A theme in what you write focuses on the real struggle to trust and feel safe in any relationship when you have survived such abusive experiences in the past. If you have predominantly experienced sexual activity as abusive/aversive, it is not surprising that you struggle to have confidence in establishing a healthy new relationship. It is also   understandable that talking about very personal and intimate issues in therapy or with anyone else would be a challenge until you are emotionally ready to do so.

The situation with the male colleague at work would be tricky enough without a background such as yours, so your reservations are quite normal! However, for survivors of CSA it is really important that when looking to start a new and healthy relationship, you are aware of the danger signs that may indicate you are being ‘attracted’ to an unhealthy partner. This is linked to ‘lifetrap chemistry’, where your own lifetraps draw you towards what is familiar rather than healthy.

For example, a client of mine  had survived  a number of abusive relationships and had a number of lifetraps including defectiveness and emotional deprivation. She had learnt over time that she could not expect a loving caring relationship because she was fundamentally flawed. When she met a man who bought her flowers and treated her with love and respect, it felt so uncomfortable and so challenged her lifetraps/beliefs about herself that she soon ended the relationship. She then fell into another abusive relationship which felt familiar and fitted with her lifetrap driven beliefs about what she deserved.

So it is important to recognise the warning signs that may indicate an unhealthy attraction to a potential partner. Conversely, it is also important to be able to recognise the signs of a healthy relationship, and be ready to battle the lifetraps that might try to sabotage it, as happened with the example I gave.

Of course starting a relationship with a work colleague has its additional risks compared to that of a relationship outside of the work environment, but some people do meet their potential partners at work!

It is good that you are now in a place where you want to talk about avoided issues. It seems appropriate that the therapist apologised for pushing you to talk before you were ready, as you need to be in control of the process and not be pressured to do anything you are not prepared for. In the short term if you are waiting for therapy, you could try drawing up a list of the warning signs in a potential partner that should set the alarm bells ringing. Think about previous abusive partners and what attracted you to them in the first instance, and whether these attractions were the pull of lifetraps rather than positive attributes in the individual. This is why it can be very helpful to identify your own lifetraps, so that the warning signs can be more readily identified. The other important thing in establishing trust a new relationship is not to disclose too much too soon. Take time to establish that the individual can be trusted with smaller bits of information that you share before trusting with parts of your history that could leave you vulnerable if they turn out to be unreliable and untrustworthy.

 I hope your appointment with your doctor is helpful. Whilst most people would prefer not to take medication it can be helpful in stabilising mood,and aid the therapy process. When you do get to see a therapist, s/he should be able to work with you to achieve the goals you have and break  the patterns of behaviour that prevent you achieving the change you desire. Your question suggests you have unresolved issues that need therapist help to resolve, so when you have established trust in your therapist, confront with them your avoidance of the problems you state if you can, as this new behaviour is likely to achieve healing and change.

Question 56 : My apologies if this comes out in a mess, but this is basically how I

am feeling internally. I am a survivor of CSA, physical, emotional and

neglect. I had worked very hard with my healing and had been fairly

emotionally stable for the past 8 years. I have all this time still

been under the mental health team up to this point but it was more to

keep me monitored and ensure I was still stable. About 4 years ago I

completed a 16 month therapy group for dealing with the effects of

sexual abuse. This group created more chaos for me due to there being

a guy on the course who by his behaviours towards myself and other

females in the group was hitting all my radars that he was an abuser.

The leaders of the group had reassured me prior to joining this group

that they did not permit sex offenders to participate in this group.

So I tried hard to believe that they would not put me or anybody else

in such a vulnerable position. However I couldn’t ignore the impact

and effect this guy had had on me. Talking it through with my care

coordinator who is a mental health social worker, she too agreed that

there was things in the guys behaviours that were very predatory and

agreed that this group had in fact caused me more emotional distress

and harm than ever.

Due to this experience and in that I was fully aware that I have never

really worked in detail on the sexual abuse side of my life, and I had

experienced sexual abuse from at least 4 different people in my

childhood, 2 being family members, I had requested to go back into

therapy to work on these issues, as they impact my life to the point I

am nearly a recluse.

I am due to finally start this therapy this week.

However, due to recent horrendous life events, I am now concerned that

this therapy is now going to be taken up with working through what has

recently happened in my life in the last month and not on the initial

reasons of why I am going. I have only been allocated a years worth of

therapy with a psychologist due to service cut backs. I know this is

very long, but I don’t know how to shorten it so you get a full

picture.

During the SA group, I had built up a friendship with one of the other

participants. This person was in the process of transitioning from

male to female. When she left the group, our friendship grew to the

point we would go out socially and I was introduced and integrated

into her family, especially with her sister, who too had been SA by

the same uncle. I became very close to E as I will call her and also

very close to the sister J. A month ago E passed away after suffering

with cancer. I had been with her right to the very end. She had asked

me to look after her sister. During our friendship, E had asked me

many intimate questions about my life and the details of the types of

abuse I had endured and how I perceived they had effected me. I had no

reason at this time to think anything more than that she was being

loving and caring in a friendly platonic way.

Needless to say when she passed away, I was devastated. I went and sat

with her in the hospice after she had gone for several hours and also

visited her at the funeral home. I also wrote an eulogy for her

funeral.

 

Prior to her diagnosis, I had pulled away from her as there was an

incident where she was verbally and emotionally very vile to me very

publicly in front of her sister and several other people, and at that

time I recognised she was in fact enjoying seeing the pain she was

causing me. But me being the person I am, upon finding out about her

diagnosis put this to one side, because I still cared deeply for her.

After her death and just before the funeral, her oldest daughter

contacted me to ask to come and talk to me about E. I was apprehensive

so asked in what aspect did she wish to talk. Her response was that

she needed to talk to somebody who could be honest as she needed to

understand who E was. This at the time angered me as I had been lead

to believe that the daughters had pulled away from E due to her

transgender issues, and I felt that trying to understand their

father/E now was a little too late, but I still agreed to this

meeting.

During this meeting many things E had told me in the past began to

take a whole new twist. It became very clear to me that E was very

abusive to her daughters all through out their lives, and the stories

she had told me were clearly not as they really were. The incident I

too had been on the receiving end then made more sense to me how much

she really did take pleasure in creating pain on other people and by

using confidential information she had gleaned out of me and others

she then was using this for her own gains.

Then the horror was disclosed to me. The reason E was put into that SA

therapy group where we had first met was because it was in fact part

of a 2 year probation order for the conviction of downloading, and

printing of images and videos of child abuse. It was her own daughter

who had reported her! The quantity was a large brief case full and

only this weekend I have found out there was also a large suit case

full of videos, images. This weekend I have also found out that the

youngest daughter who is in her early 30s is now getting flash backs

of being SA by E her father.

We are also told that E kept a lock up in another town, which has yet

to be found, but we all have strong thoughts that more child abuse

evidence will eventually be found.

I am now at the point emotionally I am destroyed, I am under constant

supervision by my mental health services as I am fighting hard not to

kill myself. I feel betrayed, violated and abused all over again. I

cannot get out of my head that she deliberately set out to befriend me

to use me and my life for her own personal deviant behaviour. Due to

both daughters and her sister and I getting together nd sharing all

that we have so far, we all believe that her transgending was all just

a ruse and a very clever and manipulated cover up of the abuser she

really was.

I am convinced that she is in my home. I keep smelling strong odours

of BO and though I have checked with visitors if they can smell it

they cant, I smell it most of the time. I am having nightmares every

time I do manage to sleep, the latest one of her being carried in in

her coffin, but the lid was off and I can see her face.

I’m not really sure what my questions are apart from, because I feel

somehow responsible because I gave her some of the knowledge of how SA

impacted me and she I now believe was actually getting off from

hearing about it. I feel as though I have allowed myself to be abused

all over again. Part of me doesn’t want to believe that somebody

could be this manipulative, because the person who I loved and cared

deeply for, I allowed in. Was our friendship all just a lie. Can

abusers really be this manipulative and how the heck can I ever come

back from this and feel safe to trust anyone again. I am a shell of

myself now, and it is all due to this. Also how could a pyscho therapy

group funded by the NHS outwardly lie by saying they don’t allow sex

offenders in these groups and put us in such vulnerable positions.

Surely they have a duty of care. Why and how did this all happen, and

why has this knocked me so much that I cant bare to be alive. Why did

I yet again love an abuser.

 

Answer 56: This is a very complex situation that you describe, and I can understand why you are concerned about how you might best use the therapy you are about to start. It would be very helpful for your new therapist to have the detail of this question to help in the assessment of your problems and collaboration in the setting of your goals from the therapy. The emotional chaos you are reporting reflects the level of deceit and betrayal by E. It is very important that you know you are not in any way responsible for E’s abusive behaviour. She knew exactly what she was doing, you had no idea of her background history (nor did anyone else for a long time from what you say) and she took advantage of that. Abusers are by nature of the offenses they commit manipulative, abuse trust, create vulnerability and then take advantage of that vulnerability.

If you believe that the NHS misled you about the participants in the group, and failed in their duty of care, you can make a formal complaint. There should be a patient advocacy service (PALS) usually based in the hospital who can support you through the process, and all NHS services have a complaints procedure which you can activate on your own if you prefer.

I would suggest that the complex issues you detail here are not completely separate, but overlap to a greater or lesser extent. As such it is likely that if the focus of your therapy is on the CSA you experienced, it should also address issues of trust and the lifetrap chemistry I discussed in answer 55. If you read about the nature of lifetraps, they can draw us towards individuals for the wrong reason. The pull is somewhat irresistible if you are unaware where the attraction (pull) is coming from. So you do not consciously choose the abusive relationship or allow yourself to be abused, the abuser will have their own radar that picks up on vulnerability and gets pulled towards their victim. Your therapy should help you work on your lifetraps,  so that you are able to avoid the pull of unhealthy relationships.

At times of crisis it can feel like there is no resolution which increases feelings of hopelessness. In the 20+ years I have worked in the adult mental health field, I have observed many clients recover from seemingly hopeless situations, despite their pessimism whilst in crisis

It is very important that you and your therapist and other professionals involved in your care work together to help you recover from this crisis, and undertake the work in therapy which will help reduce your vulnerability to abuse in the future. I wish you well

Question 57:

I live in London and have been looking for a counsellor for some time now. I have had initial consultations with two counsellor, neither of which is what I was looking for – and have left me feeling wary of approaching someone new again. I really like what Kate has made available on her site, and am hoping that perhaps you would be in a good position to offer me some advice on where to start looking for the right counsellor. I am female and would like to deal with females for obvious reasons ,if there is a person or group that you could recommend, I would be very grateful.

Answer 57:

This question raises the important issues of the challenges of finding the right kind of therapy and Counsellor/Therapist in what can be a bit of a minefield of options! When looking to undertake therapy, it can be helpful to try and establish what model of therapy you wish to have. There are many different models from psychodynamic to Humanistic to Cognitive-behavioural and many others, plus those who describe their approach as integrative, which means they may use more than one model in the course of treatment. On their website, the National Institute for Health and Care Excellence (NICE) have listed recommended  evidenced based treatments for a wide range of mental health problems which may help you decide which approach you wish to take.  Once you have decided, you then need to go to the appropriate register of accredited practitioners for the therapy model you wish to use. On the TTW website click on the ‘other resources’ link at the top of  the home page, and then scroll down to counselling/therapy towards the bottom where there is some further information and advice and links on this topic.

As you live in London, there will be plenty of choice regarding therapist, and historically with most approaches there have been more female than male therapists so that should not limit your options of a female too much! The most important issue for survivors when choosing a therapist is to make sure that they have not only the appropriate qualifications and accreditation, but also experience of working with the problem(s) for which you are seeking help. It is always a good idea to have a fact finding chat on the phone with a potential therapist, and don’t go with the first one you call. Talk to at least two or three if possible, so that you can get a feel for whom you connect with most. The therapy relationship is an integral part of the process so it is essential that you are able to engage with and trust your therapist. I usually agree with my clients that the first assessment session involves no commitment either way to continue into treatment if the connection is not there for either client or therapist. Remember it is your therapy, so it must work for you.

If you follow these steps you at least have a decent chance of  finding an appropriate therapist to  meet your needs.

Question 58: Hi Chris,

I would appreciate some guidance in terms of where might be a good

place to seek support specifically tailored for those who are children

of abuse survivors? My mother was sadly the victim of not only CSA by

a family member, but also an alcoholic and mentally abusive mother.

After years of her repressing everything, this came to light for her

when I confided in her that I had discovered a history of abuse within

our extended family when I myself was still a teenager. She bravely

sought help and support with my guidance, but the repercussions of

what she lived through has affected her behaviour towards me (anger,

perfectionism, conditional love etc) initially subconsciously when I

was a child and now openly into adulthood, and I don’t know how to go

about finding a resolution for my own experiences.

 

Since the day I first discovered what she endured I have struggled

with conflicting emotions, mainly crippling guilt that I have

resentment towards her treatment of me when I know that she can’t help

it and nothing was her fault, and I feel selfish and ashamed that

compared to what she experienced I struggle so much with the impact

what she suffered has had on my own life as it just isn’t comparable.

She now feels, as is her right, that she wants to live the rest of her

life without her childhood hanging over her, but I don’t know how best

I can respect her wishes and support her right to this whilst also

trying to find some form of closure or acceptance for myself about her

treatment of me. I love her very much and I am so proud of her for

overcoming what she has and I desperately want to be able to forgive

her behaviour for something that she can’t help and move on and

support her moving on; I have tried various forms of counselling and

therapy but I haven’t found anything so far that has worked for me.

There seems to be a lot of support options for those who are partners

or parents of CSA survivors, but I don’t think they seem to be

particularly relevant . Any advice you could give would be gratefully

received. Thank you.

 

Answer 58: Thank you for your question which raises the often forgotten or ignored experience of the children of survivors which can be quite a complex one. You are very understanding of your mothers’ childhood experience and her behaviour towards you, but struggle with the emotional consequences for yourself. It is really important that you understand that whilst your mother may not have intentionally behaved that way she did towards you, it does not reduce or invalidate the impact that it had on you growing up. So you are neither selfish or need to feel ashamed for wanting to have your own help for the problems you describe.

There is an obvious tension in these two aspects of the problem you present, i.e. your wish to be caring and supportive of your mother and her attempts to ‘move on’ and your own need to for healing and closure for the effects on your own experience of her as a mother. The two are not entirely separate, but may benefit from a two pronged approach.

It is very evident that you have your mothers’ best interest at heart and I assume you have a reasonably healthy relationship with her? I do not know of your mothers circumstances or whether there are other siblings or family members involved so there may be other relevant factors I am unaware of. It would seem to me that both of your needs might be helped by having some joint therapy to help your healing process and for your mother to move on. A therapist with experience of working with family/systemic issues would be preferable. Alongside this you may also benefit from your own individual therapy to help you process and work on issues raised by the joint therapy. I see that you mention you have tried various forms of therapy but so far not found anything that has worked for you. Without knowing the   models of therapy you have tried already, I can only suggest you following the guidance on finding a therapist/counsellor on the TTW  other ‘resources page’ to find links to various accredited therapist registers. If you search through these you can then see what specialist areas each individual therapist offers.

From my own clinical practice, I have worked with individuals who are also in couples/family therapy and this worked well.

I hope that this gives some direction for you, and wish you and your mother a happy future.

Question 59 :

I was sexually abused by my maternal grandfather as a child & one time

my mum walked in and nearly saw what he was doing, but she definitely

did NOT see because he stopped immediately, but i’ve always had a

feeling she did see. Recently I had a dream where my mum was crying &

telling me that she should have stopped him and she should have saved

me, while I pretend not to know what she is on about. Later in the

dream she makes me stay at a religious priests house. Do you think

this dream represents anything? Am I trying to gain forgiveness for my

“sins” by staying with a religious priest? Or am I just looking into

it too much?

 

Answer 59: Dreams are subject to much attention by various professionals and others, and you may have even searched online and seen the  enormous number of people/organisations claiming to  offer you the opportunity to interpret/have interpreted, your dreams. Some are there to part you from your money, but others may well have a good go at helping you to understand your experience based on their training and/or experience.  The content of your question has two elements. The first is that the NOT is in capitals indicating certainty that your mother did not see your maternal grandfather abusing you. The next part of the sentence suggests that you feel that she did see and knows what happened, but did nothing about it. This may mean for the child being abused, that there is some unresolved ambiguity about what you needed and might have expected from your mother at the time of the incident.

The second part, the dream you describe, is very evocative of the internal struggle for the abused inner child who needed her mother to protect her from the abuser, and the apology from her for not protecting you, appears to validate your (waking) feeling that she did really see what went on. The bit about making you stay at a priests house sounds like force rather than a caring act, but it may be how I have read it. I don’t know whether you grew up in a religious environment or currently have religious beliefs, as this may have a role in the content of your dreams.

We know that dream themes are often similar or the same as themes when we are awake, and that the brain will process unfinished business from our waking hours when we are sleeping.

The line about seeking forgiveness for your ‘sins’ (which in the case of abuse you have not committed!!) may link to any underlying religious beliefs or not.

The truth is we can only have an educated guess as to what dreams mean. From what you have said I would hypothesise that your abused inner child may well benefit from some therapeutic imagery and rescripting in order to help the  inner child get her needs met and experience some healing. The book reinventing your life does explain how to do this, but as I have said before, an experienced professional may be needed in the first instance. It is also not clear whether your mother is still part of your life, as there are also therapeutic interventions that can be considered, if appropriate, which include her. Again this might also benefit from  therapist input, to work through the pros and cons of this and how to safely go about it.

Question 60:

how can i overcome my fear that i am going to lose anything good that is in my life. i have abandonment issues from childhood and no matter how hard i try i cant seem to believe that i’m good enough or lovable or likeable .

Answer 60: This question has a clear suggestion of the defectiveness and emotional deprivation lifetraps, as well as the abandonment mentioned. Fear or expectation of abandonment can cause an individual to ‘get in first’ and create a situation or reason to abandon those they fear will abandon them. This can often be people who are not intending to abandon them, but because of the lifetrap activation, the individual does not wait long enough to learn that their  fear is not realised. This results in the very thing the individual did not want, i.e. the people they want around leave because they are pushed away or felt unwanted. The three lifetraps, defectiveness, emotional deprivation and abandonment are part of the domain known as disconnection and rejection, which has the effect of creating an expectation that core needs, such as nurturance, empathy, acceptance and respect will not be met in a predictable manner. Typical family of origin would be detached, rejecting, explosive, unpredictable or abusive etc.

This would therefore suggest that the inner child still has unmet needs that require addressing in a therapeutic manner. The reinventing your life book has chapters on these lifetraps with ideas how to go about changing them. Help from a therapist for experiential interventions such as imagery can aid the process. Lifetraps are very powerful drivers of emotions when activated, and unless the triggers for the activation are addressed they are unlikely to heal on their own

Just because we fear something is going to happen, does not mean it will happen. Sometimes when lifetraps are activated we apply the same solution each time which produces the same unsatisfactory outcome. Getting help to find a different, more adaptive solution has a better chance of producing a healthier and healing outcome.

Question 61:

Hello, I am desperate to help my 31 year old daughter but do not know

where to turn. We are English but now live in France and my daughter

has recently come to live with us here, as she cannot cope with life

alone and everyday living. She is the mother of 2 young children.

My daughter was sexually abused by her brother, as a child, and only told

us about it recently. We had no idea this happened. My husband and I

just do not know where to begin to unravel the anger and hurt she has

bottled up inside her. There is obviously so much more detail involved

in what happened and where we are now. I just am at a loss what to do

to help her!

 

Answer 61: I am very sorry to hear of the difficulties your daughter is experiencing as a result of the CSA by her brother. I am sure many other survivors will recognise and empathise with the psychological distress she is going through.   My first thought is that she has recently moved to a different country, where she may have difficulty accessing services as well as the potential language barriers. On your own I think it will be a challenge for you and your husband to meet the needs that she has now. CSA by a family member has the potential for quite complex family dynamics, so some professional input would be indicated and perhaps some family sessions might help as well. It is not clear from the detail you have provided whether your daughter has sought or received any help previously. She will need support to be able to therapeutically process the ‘bottled up’ emotions you describe, and a skilled therapist should be able to help her do this.I am not aware of the public services she may have access to in France but you should be able to find an English speaking( or French!) therapist in France through an online search. Just check that they have a recognised accreditation. Obviously your daughter could return to the UK for help, but this may not be practicable or desirable.The support you can give her is to validate her experience and emotions, help her locate independent help, and  be available for her during the healing process.

Question 62:

hello i have been through counselling for child sexual abuse, twice

but i found it difficult to talk to the counsellor, which i was

allocated, i didn’t realise i could choose to see someone different

and i didn’t want to hurt her feelings, as she had suffered a stroke,

and i have very low self esteem, i tried to go back but now suffer

from agrophobia, panic attacks and anxiety, anorexia and i was unable

to attend, they then told me i had had enough counselling. i feel as

though my lifeline has been cut, even though they provide only basic

counselling provision,it was better than nothing. i was physically

assaulted recently and this seems to have triggered everything again

for me, in terms of fear, panic and men. i’m very very low at the

moment but i don’t know where to turn to, i will probably phone

lifeline again as they seem to be the only people there.My question is

what organisations have fully qualified/trained staff to deal with

counselling child sexual abuse survivors, because there doesn’t seem

to be specifically designed counselling for survivors of child sexual

abuse, or protocols which protect and explain our rights, it seems to

be one size fits all, and treated as though it’s something trivial,

and all in the mind and if you don’t respond tough, it’s your own

fault or that there’s something wrong with you. what checks do

counsellors have to go through in order to counsel someone whose is an

adult survivor? are they just volunteers off the street, who’ve done a

counselling degree with no regard for child protection or vulnerable

adult protection.

 

Answer 62: I am sorry to hear of your negative experience of the counselling you were offered. The therapy relationship is vital to the therapeutic process so if the dynamics between therapist and client are not healthy it is likely to affect the therapy outcome. To answer your question about which organisations have fully trained/qualified therapists, you might like to look in the ‘other resources’ page on the TTW website and scroll  down to  the counselling/therapy section for guidance and some  organisations who have an accreditation process for those with the appropriate minimum training to  meet their requirements.  It is still important to ask any potential therapist what sort of experience they have of working with the particular problems you are seeking help with. There is specific training for working with clients who are  CSA survivors, which maybe part of the training course content for some therapists.

CSA is never trivial, and any suitably trained and experienced therapist would never suggest otherwise. All therapists are required to sign up to a code of ethics in which they agree not to offer therapy outside of their area of expertise or competence. All therapists should be receiving regular clinical supervision to ensure their client work is being conducted appropriately to agreed standards and protocols. Therapists would also need Criminal Records Bureau (CRB) checks to protect vulnerable clients from those with inappropriate backgrounds. Training in safeguarding children and vulnerable adults should be part of the training for all therapists. I don’t know which organisation offered the counselling you described above, but local NHS services should be able to provide appropriate therapy, depending on resources available. Otherwise the organisations listed on the TTW website will have experienced therapists on their registers, but fees will be charged.

 

 

Question 63:

My partner is a CSA survivor and this is something he told me very

soon into the relationship. We worked through the subject and finally

I made him realise that I love him all the same, he was obsessed with

the thought if find him disgusting which I know is very common. We

have been fine now for over a year and the topic is rarely mentioned

unless he is thinking about it or feeling down. I’ve recently found

out his abuser contacted him about 6 months ago and they have been in

contact since. I’m ashamed to say, as I don’t understand why my

partners would want to talk to him again after the incident and also

how my partner describes his hatred for this man, that I went through

his messages to his abuser and this is where I need help.

They are discussing what happened the abuser has told my partner he

still loves him and is speaking to him as if they are a couple. The

abuser also mentioned a new child he has been spending time with and

abusing. Once I found all this out I brought it up with my partner and

we spoke about it, I understand more now that when they were speaking

he felt like a child again and couldn’t do anything about the

conversation he felt powerless to say how he felt and just fell back

into old ways. I understand all this, at least I try to, but what am I

supposed to do now. My partner won’t stop the relationship, he told me

that if I do anything to get his abuser in trouble (tell the police

about the new 14 year old boy) he will be so distraught he would hate

me for the rest of his life. I want to take a break from our

relationship to work everything out in my head because I feel so

guilty about the new child and knowing it’s happening and to work out

this relationship with his abuser because I can’t carry on a

relationship when he saying things like ‘I miss you too’ to him. Am I

being selfish wanting to take a break? Should I sacrifice my

relationship and go to the police about the abuser (my partner never

went to the police as his parents told him not to when it happened)?

And finally my partner is unstable with all this new stuff happening,

if I do take the break I need how do I not feel terrible about what it

will put him through?

 

Answer 63: Thank  you for  sharing this  complex situation that you now find yourself in. The most important issue here is about choices and consequences. Your boyfriend has chosen, for whatever reason, to have contact with his abuser who is currently sexually abusing a child. It is not clear how old he was when he was abused, but from your question that fact that he told his parents about the abuse suggests he was a minor at the time? If he chooses to continue the contact/relationship with his abuser, despite the consequence of potentially losing his relationship with you, then that is his responsibility. He is also colluding in the ongoing abuse of achild by doing nothing when he knows it is going on, and through his threats to you if you disclose the abuse.

It is essential that you put your needs first and take a break from the relationship if that is what you need to do.  It is not selfish at all to distance yourself from what is currently a dysfunctional relationship. The consequences of any decisions or actions you take as a result of your boyfriend’s behaviour are his responsibility for the choices he has made.

If you have sufficient information to identify an active abuser and prevent further abuse, what would you advise someone else to do in the same situation? Your boyfriend appears to be stuck in a schema driven abusive relationship with the abuser and he is therefore unable to take what he knows is the right action. The guilt you describe as a result of knowing the new child is being abused, suggests you know what you would like to do to protect the child but feel it’s a difficult step to take. It may help to contact one of the helplines in the ‘other resources’ section on the TTW website to talk it through with someone can who support you through the decision making process.

Question 64:

Hi, I’ve have always managed to bury what happen to me, but a recent

event has brought back some unwanted feelings and behaviour. I have

never been able to tell anyone. I know I need help but dont know how

to begin, I can’t even say it out  loud to myself. I don’t want anyone

around me to know, so would like to deal with this on my own. What can

I do?

Answer 64: It’s not too surprising that toxic memories that have been suppressed or buried have been activated by a recent event or trigger. The fact that you felt the need to bury what happened to you indicates that there are some unprocessed emotions which you didn’t want to experience for fear of being overwhelmed or something similar. The fact that you have not told anyone about your abuse makes it that much more difficult to deal with.

I remember many years ago seeing a woman who had been abused at least two decades before our first appointment. Her GP had referred her for   help with depression, but during the session she disclosed the abuse, and I was the first person she had ever told. At our second meeting she reported how much better she felt having told someone else who believed her and validated her experience. The reason I share this is that I think it might be quite therapeutic for you to talk confidentially to an appropriate person, such as your GP or one of the helplines from the resources page on the TTW website( where you can maintain  anonymity ).  That may be  as far as you want to go, or you may find a resource that can help you  and find a way to process unwanted feelings. Disclosing for the first time can fell very scary, like losing control over something so important. It can also be a very liberating experience that is a catalyst for change. You have nothing to lose by talking anonymously on an appropriate helpline in the first instance.  There are also many books which can offer  help  and advice, links to  some of  which you will also find on the TTW other resources web page. The first step is usually the most difficult, but sharing a burden can lighten the load.

Question 65:

I currently speak to a local minister, she has and is the only person

who i have been able disclose everything too. she is really good,

although she will say she’s not a counsellor now, she has been trained

in the past and used to do therapy with kids. I have been to my gp,

who knows i speak to this lady, and gp said i need specialised

counselling, she referred me to the gp service to be told by the

counsellor that they could only offer me 6 sessions.. so that’s a no

go.. My problem is not talking to this lady becuase i want to carry on

talking to her. my problem is dealing with the emotions after! i come

home and have to function for my family but i just want to be left..

How do i function as well as deal with this journey of emotions..

 

Answer 65: You describe a very  difficult dilemma. That fact that the local minister is the only person you have made a full disclosure to makes her a very important person in your life. She has been honest in stating that she has limitations in her training which may limit what she is able  to offer you. It is clear that you are indicating the need for coping strategies to help manage your emotions following your contact with the minister. It is a fundamental part of the therapeutic process to teach the client appropriate skills to manage emotions outside of the therapy session.  I would agree with your GP that you need specialised therapy to deal with your problems, and this would normally be offered through the NHS. I am wondering whether the service that is able to offer you six sessions would also be able to refer you on to longer term therapy within the NHS if appropriate. This is a common route to services since the introduction of IAPT (Improving Access to Psychological Therapy) services across the country.  It may be worth talking to your GP or the therapy service provider to find out specifically what they offer and whether they can refer you on to another service.  In the meantime, have you talked to the minister about your emotions following  the sessions with her, and whether she has any helpful suggestions as to how you might cope? You could also look at the TTW resources page to  see if to see if any of the organisations listed could be of help.  It is important  you understand that you are doing your best to cope at present, but without additional specialist help the difficulties you describe are unlikely to significantly change.

Question 66 :

I had an extremely abusive childhood after my mother died a month

after i was born. Emotionally and at times physically by my alcoholic

father. So much so that I spent 3 of my first 8 years in council run

care homes. I was sexually abused both in care and by several of my

fathers brothers i believe between 3 and 7 years of age.

 

My question is; Do you believe that csa survivors can compartmentalise

periods of abuse, so much so that they can’t always remember the abuse

itself?

Most children have very few memories of life in their first 6 years

anyway.

Even though I don’t really remember all of the abuse itself, my

feeling is that the trauma it caused has made me block much of it out.

Manifesting itself in different ways, such as anger, self harm and

depression.

 

At times I feel so worthless and alone

Answer 66:

A simple answer to your question is yes, CSA survivors can and do compartmentalise or block/avoid memories of abuse in order to protect themselves from the unwanted feelings/emotions associated with them. You are correct in attributing current problems such as anger, self-harm and depression as manifestations of the CSA psychological trauma. It is known that children do the best they can to cope with abusive events at the time, and engage whatever strategies they can to survive the trauma. Whatever strategies are employed as a child, they don’t tend to work in adulthood, hence the experience of many survivors of triggers bringing to the surface previously blocked/avoided or compartmentalised episodes of abuse. A lot of mental energy goes into suppressing or avoiding abusive memories, with the manifestation of the mental and physical problems you describe, so it is important to have professional help to process the trauma in order to remove the need for the blocking/avoidance.

Question 67:

Hello Chris,I was sexualy abused for 19 years by my older brother,and

have been recently been coming to terms with the facts that it was

known and no one helped me.I have not disclosed to anyone including my

husband.I feel ashamed to tell him but feel deep down he needs to

know.but he is aware i have nightmares and that i see a counselor.How

can i prepare myself to tell him without feeling like im a bad

person?As I feel i may disclose at some point.Thanks

 

Answer 67: You describe a common experience of survivors of CSA, i.e  how to manage the  disclosure process whilst still having feelings of guilt and shame about what happened to you. You are not a bad person. The person who abused you is the bad person. I am pleased that you are in therapy with a counsellor and I think it would be appropriate for you to talk through this issue with her/him so that you can prepare for the disclosure to your husband when you feel ready to do that. Sometimes it can be appropriate for the disclosure to take place in a joint counselling/therapy session with your partner if this feels safer.  It is my professional experience that partners of survivors are usually very supportive when disclosure takes place.  The important issue is the preparation prior to the disclosure and the support during and afterwards where needed.

Question 68:

I am a mature (70 year-old) man who has had symptoms of

hyper-vigilance for as long as I am able to recall. I was ‘fiddled

with’ sexually as a child aged between about 4 and 7 by an older

female cousin. Instead of this putting me off matters sexual, it seems

to have heightened my interest in certain specific areas. I would add

that I have not acted on these in any improper manner.

Additionally, being brought up in a single mum family, but with

grandparent figures available, I was aware of a constant FEAR that my

mother would run away. She said so frequently whenever anything went

wrong, and often screamed it out. I always seemed scared and reacted

accordingly, always being ‘good’ and checking where she was. Now,

although I TRY to live what passes for a normal life, I am more and

more aware of being on the alert for risks – mainly intruders/would-be

burglars. We have in fact been burgled twice in 15 years which hasn’t

exactly helped my worries. My wife is caring and as far as she is

able, understands. I have not shared this issue with my GP or any

other health professional, though I did benefit from CBT for anxious

depression some time ago (20 years’ish). How can I move forward toward

a more sane lifestyle please?

Answer 68: The hyper-vigilance you describe is a common symptom of abuse, linked to the trauma of the abuse episodes. The fear of abandonment by your mother and the need to keep checking that she had not acted on her threats to leave will also have contributed to an anxious coping style. The fact that you have also been burgled twice can only add to the hyper-vigilance. You describe having benefited from CBT for depression and anxiety in the past  so it may well be that you would benefit from another course of therapy now. A comprehensive assessment of the history of your problems, and your current coping strategies could help inform treatment interventions to help overcome the anxiety that has been with you most of your life. I would suggest talking it over initially with your GP to see what the NHS is able to offer. S/he should be able to get some CBT sessions for you within the NHS structure. If you wish to go privately then there are a list of organisations on the TTW website under other resources.

Question 69:

I was sexually abused when I was 4. I am trying to work through the

feelings in therapy. At night, I experience a child inside me who is

scared. There is pain between my legs. Is this normal when processing

sexual abuse memories? There is nothing physically wrong with me. I

feel like I’m going crazy. My memories of the abuse aren’t even clear

and I am worried I’m making it up. Also, when I was a child I used to

wet myself. The child inside me now is terrified this will happen

again. I am so ashamed of these anxieties. Could they be related to

the abuse? I feel so confused and bad inside.

Answer 69: It is not unusual to have these kinds of experiences whilst in therapy and they are almost certainly related to the abuse.  Depending on what model of therapy you are undertaking, reliving the abuse can be part of the therapy process in order to change the beliefs and emotions associated with it. It is essential that you discuss these issues with your therapist so that they can help you develop adaptive coping strategies and skills for use between sessions. There is nothing to be ashamed of and I understand that these physical experiences can be confusing. You have a traumatised inner child who needs help to feel better, which should be a goal of the therapy. Most survivors of abuse have developed beliefs about being bad/worthless/defective which are usually in response to trying their best to make sense of what was being done to them. The beliefs are faulty, and this is a key area of focus for therapeutic change.

Question 70: I havent told anyone about what he did to me. I feel that I am

pretending to be someone i’m not. To other people looking at my life I

seem to have it good, a husband, two beautiful children and a great

job. I know I should me happy, but it all feels like a big lie. I have

found myself wishing for something bad to happen to me, something that

I dont have to keep secret. I think its so when I do feel at my worst,

I can justify the tears or sadness to people around me. Or maybe I

just deserve to be hurt or unhappy. Im so confused about this, feel

like I must be going mad wanting this. Is this “normal”?

 

Answer 70: You don’t say who the “he” is, but I will assume it was someone from your childhood that abused you. You may well have a good life now but CSA causes untold misery whilst it remains unresolved. You are not living a lie; you are doing what you have done during and since the abuse, coping the best you can. It appears that you have not told anyone about the abuse or had any help to cope with it. What you describe is wanting or needing validation of the emotional distress of the damaged inner child, and being able to express this.  Coping strategies employed as an abused child are often adaptive then, but don’t tend to be so in adulthood. You do not deserve to be hurt or unhappy, and the confusion you describe is understandable when you have kept secret something so traumatic. It is really important that you find someone you trust to confide in, such as your GP or another professional. You need help to process the unresolved emotional distress resulting from the abuse so that you can rightly enjoy the life you have now.

Question 71: I’ve tried person centered counselling but come up with blocks. My

problem is me, I can talk about abuse, rationalise effects speaking as

an adult. If I talk about it as if it was then my mind goes blank and

I see mechanics but no emotion, ask me how I feel and I have no words.

I do have a scary high pitch ringing in my ear like the nothingness is

pulling me in. I think I’m ok and then my body lets me down. One

trigger word can send me straight to being sick, shaky and the ear

thing. Then I spend the rest of the day sad and feeling the lowest of

the low. I don’t want nasty surprises anymore so could u recommend any

particular way forward please.

 

Answer 71: From what you describe it would seem that you have difficulty connecting emotionally with the experience of the abuse if you attempt to relive it as the child you were. This is not an uncommon experience for survivors, as there is often a fear of being overwhelmed or re-traumatised if the defences developed in childhood are lowered. It requires a skilful therapist to help a survivor find a way through, which might involve a negotiated series of gradual steps to aid the process. Developing grounding techniques and safe images are also part of the therapy to help with possible dissociation and powerful emotions. I don’t know if person centred therapists are trained to offer this kind of intervention. You could ask your GP about seeing a psychologist within the NHS or try the BPS or BABCP websites to see if you find an experienced therapist to help you with your difficulties. Remember, it is important to ask any therapist about the experience they have of treating individuals with your kind of problems to satisfy yourself they are right for you.

Question 72:

 My abuser was my brother, he is 2 and a half years older. When i

remember it starting he was a teenager. When reading about abuse, it

so often refers to abusers as adults. I understand in these situations

that the child carries no blame, that its not their fault. But when

the abuser is still a child themself, how can it be their fault? I am

so confused, l didn’t want it to happen, but if we were both children

surely we are both guilty. Or if as a child I did nothing wrong, then

maybe as he was a child he did nothing wrong. I just can’t get my head

around this

 

Answer 72: Abuse by a sibling does have a more complex psychological element to it, and the question you pose demonstrates this well. It is important to differentiate between two children exploring their bodies in a non – sexual consensual manner, as opposed to a child being sexually assaulted and abused by another child where there is no consent and it is experienced as abusive by the victim. Your brother was a teenager and would almost certainly  have been very well aware that what he was doing was wrong. I suspect his behaviour around the abuse, secrecy and opportunistic timing of assaults would indicate that he knew he needed to avoid being caught. Whilst I am having to speculate on this, the fact that you did not want it to happen indicates abuse, and he would have known you were not a willing participant.

The reason why he abused you is another issue, but it does not detract at all from his responsibility for the abuse.

Early on in my career I was involved in a child protection case where a boy in his early teens had abused two young girls. He ended up before the court and he was sentenced to a specialist treatment centre from which he was not allowed to leave until it was deemed safe for him to do so. The child victim carries no blame – a teenage abuser is responsible for his actions.

Copyright © Kate Swift 2013. All Rights Reserved.