Specific Psychological Distress: Abuse and Trauma

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Specific Psychological Distress

Abuse and Trauma

Bass, E. and L. Davis (1988) The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse. New York: Harper & Row. [Amazon UK | Amazon US]

With a mix of facts, insight, down-to-Earth practical advice, and profiles and first-hand accounts from women who have survived sexual abuse as children, this is regarded by many as the leading guide for healing. It will be of use not only as a self-help guide, but also to educate counsellors and psychotherapists working with survivors of abuse. (However, see Draucker 2000 for a volume better suited specifically for counsellors and psychotherapists.) The single greatest weakness of this book is an apparent lack of care with respect to the risks of false memories. See, for instance, Loftus (1993) or Lindsay and Read (1994) on this topic. Note that the book focuses exclusively on women; Sonkin (1992) focuses on male survivors.

Briere, J. (1996/2002) 'A Self-Trauma Model for Treating Adult Survivors of Severe Child Abuse', in Briere et al. (2002); pp. 140-57 of first edition.

This is one source for the idea of the 'therapeutic window', that middle ground where appropriate therapeutic interventions can be made, 'neither so nondemanding as to be useless nor so evocative or powerful that the client's delicate balance between trauma and avoidance is tipped toward the former' (p. 146 of 1996 first edition). Working within the therapeutic window enables the client to make progress at integration without risking becoming overwhelmed. This requires that the counsellor balance exploratory interventions (exploring the trauma) with consolidation interventions (providing safety and support).

Briere, J.; L. Berliner, J. Myers, T. Reid, C. Jenny and C.T. Hendrix, eds. (2002) APSAC Handbook on Child Maltreatment, Second Edition. London: Sage. [Amazon UK-hardcover | Amazon UK-paperback | Amazon US-hardcover | Amazon US-paperback]

This comprehensive volume addresses child abuse and neglect from a wide range of perspectives in psychology, law, medicine and social work.

Cole, C.L. and E.E. Barney (1987) 'Safegaurds and the Therapeutic Window: A Group Treatment Strategy for Adult Incest Survivors', American Journal of Orthopsychiatry 57: 601-9.

This is an early exploration of the idea of the therapeutic window, with the recommendation that the counsellor should monitor carefully the intensity and duration of the client's engagement with abuse memories and affect, to ensure they stay therapeutically manageable. Also see Briere (1996).

Draucker, C.B. (2000) Counselling Survivors of Childhood Sexual Abuse. London: Sage. [Amazon UK-paperback | Amazon US-hardcover | Amazon US-paperback]

If I could have access to only one book about childhood sexual abuse, this would be it. Although it occasionally reads like one long literature review, the volume covers the topic very thoroughly, includes many case examples and one longer case study, and clearly flags areas where counsellors and psychotherapists should acquire additional background before attempting particular types of therapeutic work. The core of the book is the exploration of a therapeutic process beginning with initial disclosure of abuse and subsequent focusing on the abuse, reinterpretation of the abuse from an adult perspective, examining the broader context of the abuse, making changes, and addressing various resolution issues (including the search for present meaning in the experience). The book should be helpful to every counsellor working with survivors of childhood abuse, and even for practitioners working within traditions that eschew the idea of acquiring 'expertise' in a field, it will still be valuable for its reminders about behaviours likely to be detrimental to the client, however genuine and empathic and well-intentioned they may be.

Hawkins, J. (2002) 'Paradoxical Safety: Barriers to the Actualising Tendency, and Beyond', Person-Centred Practice 10(1).

This article is seemingly a move toward theory development surrounding abuse and recovery from abuse, but most of the outline offered here is descriptive rather than explicative or predictive. A significant opportunity for connection with a vast body of clinical evidence on the effects of childhood trauma is missed, with the author offering just a reference to a popular magazine article as the primary link to physiological data which might buttress her exposition. Subsequent allusions to chronic anxiety and hyperarousal could be nicely supported with references to the same body of clinical evidence, and depression could be positioned within the landscape Hawkins is exploring. (For example, see Nemeroff 1996 or Nemeroff 1998 in the section on Psychobiology and Psychopharmacology.)

Jehu, D.; C. Klasssen and M. Gazan (1986) 'Cognitive Restructuring of Distorted Beliefs Associated with Childhood Sexual Abuse', Journal of Social Work and Human Sexuality 4: 49-69.

The authors explore techniques for helping clients overcome the kinds of cognitive distortions which impact many adult survivors of childhood abuse (such as the idea that the abuse must have been their fault, or that they must have enjoyed it because they did not put a stop to it).

Lindsay, D.S. and J.D. Read (1994) 'Psychotherapy and Memories of Childhood Sexual Abuse: A Cognitive Perspective', Applied Cognitive Psychology 8: 281-338.

This article serves as a stark warning of the risks of therapists inducing false memories through well-intentioned attempts to help clients recover and integrate memories. Experimental evidence suggests that many factors common to memory recovery therapies also contribute to the likelihood of illusory memories (e.g., 'perceived authority of the source of suggestions, repetition of suggestions, communication of information that heightens the plausibility of the suggestions, encouragement to form images of suggested events and to reduce criteria for the acceptance of current mental experiences as memories', p. 294). Also see Loftus (1993).

Loftus, E.F. (1993) 'The Reality of Repressed Memories', American Psychologist 48(5): 518-37.

It is crucial that counsellors and therapists working with victims of significant trauma such as childhood sexual abuse be alert to the empirically-demonstrated risks of inducing false memories. This article strongly criticizes certain self-help literature (such as Bass and Davis 1988) as well as particular therapeutic techniques. Also see Lindsay and Read (1994).

Solomon, M.F. and D.J. Siegel, eds. (2003) Healing Trauma: Attachment, Mind, Body and Brain. New York: W.W. Norton. [Amazon UK-hardcover | Amazon US-hardcover]

With contributions from researchers, clinicians, and theorists, this edited collection offers a neurobiological perspective on trauma treatment and healing. On a first look, this book stands out especially for its introduction to the developmental origins of factors thought to place some individuals at greater risk of long-term effects from trauma. This book is reviewed further at CounsellingResource.com.

Sonkin, D.J. (1992) Wounded Boys Heroic Men: A Man's Guide to Recovering From Childhood Abuse. Stamford, Connecticut: Long Meadow Press. [Amazon UK | Amazon US]

Although not nearly as long as Bass and Davis (1988), which provides advice focused specifically on women, this book does offer a similar approach to recovering from childhood abuse of all kinds and to breaking the cycle of violence; it will be of great use both as self-help and as education for counsellors and psychotherapists working with survivors. (However, see Draucker 2000 for a volume better suited specifically for counsellors and psychotherapists.)


This page was last reviewed by Dr Greg Mulhauser, Thursday, 14 October 2021.