“What you choose to forget comes back in disguise”
In our previous episode, “Sexual Abuse Trauma, Clinical Insights and Observations,” we discussed the effects of sexual abuse, especially in settings permissive (and therefore complicit) to the trauma. Listeners have been asking for details about the therapeutic process when working with trauma. Today, we deliver.
It is important to lift the veil off of what happens in psychotherapy when working with sexual trauma. We discuss the techniques I use when working with adult survivors of childhood sexual trauma. We also generalize these techniques to incorporate age (childhood and adult), and physical abuse.
Audience and Disclaimer
The information provided is intended for therapists and clients alike. If you are a clinician who is interested in working with sexual trauma, this will be a robust introduction to the work. The material is also very useful to the general public who want to know about the in-session process.
Finally, it is important to emphasize that none of the listed methods are considered widely used, nor prescriptive – However, they are widely accepted. As a practitioner working with trauma for more than 25 years, these are the methods I continue to use myself. I also teach them to new counsellors, or those interested in expanding their approach to psychotherapy.
Resources Mentioned In Today’s Episode
John Briere is one of the leading practitioners in the field of sexual trauma. In his book “Therapy for Adults Molested as Children,” John explores the engagement between the clinician and the client as they travel the therapeutic path towards healing.
Show Outline (An Easy To Follow Guide)
- Initializing Care and the Intake – (First Two Sessions)
- Creating trust through process transparency language
- Process over content
- Building the counselling framework.
- Establish Timeline For Care
- Not all sessions are deep dives – Give permission to reflect.
- Discuss Approach Experience — Identify Physiological Indicators
- Teach Containment
- Normalize expression to “pause” during the session
- Session Structure – Beginning, Middle, and End (Process Commentary)
- Discuss session side effect awareness
- Trust Through Telling Their Life Story (not abuse directly)
- Briere, “Tickling The Dragon” — Approaching trauma
- Initiate Counseling Framework
- Identify Coping – Manipulative and Adaptive – Normalize Each
- What is getting in the way, and to what extent?
- Reflect on Counseling Experience
- Taper with Open Door
- Rushing through the rapport building process.
- Catharsis Therapy. (It’s re-traumatizing.)
- Persisting through a client/counsellor personality mismatch.
- Avoiding counselling framework for engagement.
- Over identifying with the client. (Clinicians own history showing up in the session.