This is a summary of my PhD research “Balancing Recognition and Disrespect: Recovery as the Process of Identity Formation. A New Zealand Study of How Services Shape Recovery from Sexual Abuse. These findings have been presented at the 15^th Australasian Conference on Traumatic Stress, Melbourne, September 2008. 

The study looked at the experiences sexual abuse survivors had with a wide range of services, such as hospital, mental health services, crisis services, A&E services, GP, police, social worker, counsellors, and teachers. I used critical theory and in particular Recognition Theory developed by Alex Honneth for the analysis of the qualitative study. I interviewed 10 survivors of sexual abuse and 7 providers of services for victims of sexual abuse. 

Analysis of the data uncovered the dynamics that led to recovery. Survivors of sexual abuse noticed an improvement of their psychiatric symptoms when they received recognition in the form of emotional support and care from health care professionals. Care and support enabled them to develop self-regulation skills, which in turn led to a strengthening of their self-confidence. This in turn put in motion a self-re-enforcing cycle of improvement of symptoms followed by an improvement of self-confidence. This dynamic worked similarly with recognition through the granting of rights and through solidarity. 

In contrast, experiences of disrespect caused a deterioration of psychiatric symptoms that led to a deterioration of the person’s self-relations. It set in motion a self-re-enforcing cycle of decline increasing hopelessness and bringing recovery to a halt. In some cases it led to suicide attempts. Whether survivors came out the other end and achieved recovery depended largely on having had recognition mainly through guidance, emotional support, and care. Without that level of care they did not recover. They collapsed, i.e. suicide attempts, going crazy, or going down the criminal track. 

Recovery was experienced when survivors had enough emotional support and care to resist acts of disrespect. This had occurred through them internalising recognition and balancing it with acts of disrespect. They were able to stand up for their rights and knew that “They deserved better than that”. When they realised that they are now not afraid anymore and are able to stand up for themselves, they were able to take in that they have develop a positive sense of identity.    

The Findings of my study showed that survivors of sexual abuse had to balance experiences of recognition with experiences of disrespect in order to develop their identity. Whether they came out the other end depended largely on having had guidance, emotional support, and care (Love). Without that level of care they did not recover. They collapsed, i.e. suicide attempts, going crazy, or going down the criminal track. 

A core finding of this research is that recovery from sexual abuse is only possible through engaging in the struggle for recognition and resisting acts of disrespect. By being able to overcome or resist acts of disrespect that have been described in the findings chapters, participants discovered new aspects of their identity, realised that recovery had progressed, and they became aware that they no longer needed professional assistance. Rather than continuing to respond from their ‘abuse-based identity’ of helplessness, dependency and submitting to disrespectful treatment, participants trusted their newly developed self-confidence, self-respect, and self-esteem and asserted themselves challenging service providers or any other persons they came in contact with. 

For full recovery survivors need both experiences of disrespect and recognition.  The need more of recognition in order to cope with the disrespect of the past and from their current life situations. They need to have experiences of disrespect to have something to fight against. 

When survivors have positive self-relations they can stand up against disrespect. Therapy gives them resources to overcome disrespect. It’s not ok for services to be disrespectful, but as therapists we need to know how to get survivors balanced. If everything is warm and fuzzy then survivors won’t know how to deal with disrespect.

Emotional bonds and attachments are a precondition for human functioning, prospering, and self-development. Humans and all other mammals have inbuilt neuro-physiological structures in the limbic cortex through which they attach to the parent or caregiver. This is mainly to assure that parent and child care about each other so that the survival of the species is guaranteed. The argument goes that attachments are pretty durable and don’t stop even in situations of abuse or neglect. People think therefore that attachment dynamics are kind of hotwired into our brains.

These inbuilt attachment dynamics help us understand paradox emotional states survivors of sexual abuse experience – especially when their perpetrator is a family member or parent. When abused by a person close to them, victims struggle to integrate the fundamental human task of attachment with the instinctive recoiling from pain through withdrawal or shutdown, which causes huge emotional conflict. We’ve seen that also in the form of the Stockholm Syndrome: when a person’s physical and/or mental survival it at stake, they are drawn to attach to the perpetrator in an unconscious attempt to elicit a caring response and to minimize the threat to their lives. It’s nature overruling what could be called otherwise ‘common sense’.

The dilemma occurs when the child has to attach to the parent or person that then is hurtful to him or her. The child can’t turn away … otherwise it’ll die, and struggles to attach, because the person to attach to is abusive. That dilemma is solved by the child taking on responsibility for the abuse. For reasons that make perfect sense to the child, it comes to believe that it deserved to be abused or even has caused the abuse. With this shift in thinking the child protects the attachment to the perpetrator. It also ends up having a sense of control over changing the situation. For example, by being extra ‘good’, the child might now be able to elicit a caring response from the perpetrator . For some victims of sexual abuse ‘being good’ becomes a life position of being over accommodating and over compliant with the people around them.

We often see that survivors are unable to get angry at their perpetrator … the closer the perpetrator is, the harder it gets to express anger. Although designed to assure survival, this attachment dynamic creates havoc with survivors. They struggle with shame, guilt, low self-confidence, and ….all the rest of it. To reverse this dynamic is terribly difficult and not doing so keeps many people stuck in a place of hurting and discounting themselves. However, it (knowing that you are ok, it wasn’t your fault, it was wrong what he/she did, you are loveable….) has to be the core of the healing process.

What happens when survivors do address this attachment to the perpetrator dynamic, they often become suicidal or fall into deep depression. Actually, often survivors strongly defended against addressing it. Why? It appears that the self-preservative instinct (here comes nature again throwing a curve ball) to attach is reactivated by starting to view the perpetrator as bad and hurtful and the more people are able to loosen their attachment to the perpetrator, they have intense feelings of loss, isolation, abandonment, or even impending death. Nature takes over again and the survivor of abuse might revisit the feeling ” you have to attach or you die”!

Although sexual abuse is a huge problem that affects one out of four females and one out of six males, less than 10% of survivors contact services for help. Some may not need help, some may not want help. Others may not know how to go about getting help or they don’t feel able to go and see a therapist. Lots of people battle in isolation with the impact of their past.

You don’t have to do it alone!

Do you struggle with                    

•  Loneliness
• Low Self-Confidence
• Flashbacks
• Sleep Problems
• Depression, Anxiety, Phobias
• Dissociation, Derealisation
• Lack of Trust
• Relationship Problems?

Is you answer YES to the above questions?  
Then Sexual Abuse Help is just right for you!

Don’t struggle in isolation searching for answers, wishing for someone … anyone to come along who understands you. Join the Sexual Abuse Help community today!  Here you don’t have to explain yourself, hide parts of yourself, or convince us of anything. We know where you are coming from. Relax and enjoy the support of fellow survivors!

How I Came To Know About Recovery From Sexual Abuse

Dr. Gudrun Frerichs

Being a survivor myself and having had progressed well in my own recovery, I became very interested in understanding sexual abuse during my training as a psychotherapist. It was to my great surprise that very little information and training about sexual abuse was available for budding therapists.

Living far away in New Zealand did make access to training even more difficult. I took every opportunity to study the masters in trauma-therapy and sexual abuse. I went to their workshops, read their books, and watched their videos. Bessel van der Kolk, John Briere, Collin Ross, Charlotte Dallenberg, Judith Herman, Richard Kluft, Putname, and James Chu became my teachers and inspiration.

In my almost 20 years of experience as psychotherapist in private practice I have assisted many survivors of sexual abuse on their journey towards recovery. For many, therapy became the safe haven where they felt safe enough to talk about their past experiences of sexual abuse. Here they shared their hurt feelings from not being loved and cared for in the way they needed, about being betrayed and losing trust in people, and about feeling responsible for the abuse. They talked about feeling out of control and not trusting themselves, about their shame and guilt, about their hopelessness, and about their sense of powerlessness and victimisation.

I did not have to think long when I had to choose research topics for my degrees. Of course I was going to focus on sexual abuse. It has always surprised me that a large amount of literature describes the recovery from sexual abuse from the health professional’s perspective. My interest has always been to give survivors a voice. Surely, they would have to be the experts when it comes to describing what works and what didn’t! Hence my first research has uncovered how clients with dissociative disorders handle therapy, what works for them and what didn’t. My second research revealed how services shape the recovery from sexual abuse, outlining clearly what hindered recovery and what was helpful. That knowledge combined with my personal experiences and my experiences from my clinical practice will be shown on the Sexual Abuse Help Site.

From surveys and encouraging  responses to my Multiple Voices Blog I know that survivors have been looking out for getting access to information that has been informed by their lived experiences, and for being able to find ways of networking with each other in a safe environment. The Sexual Abuse Help Site is the product of survivors’ feedback, survivors responses, survivors needs, and knowledge accumulated over 2 decades of study and practice.

Do you want to

• Be able to put the abusive past behind you?
• Have self-confidence, self-esteem, and self-respect?
• Know that you are not going crazy?
• Have meaningful relationships?
• Feel being part of your community?
• Step out of the shadows of the past?
• Build a bright future?

Imagine how great you will feel when you see that you are on the pathways of recovery and that your dreams can come true? Think about all the things you will be able to do when you learn in the company of other survivors how to develop the skills and the confidence to succeed in your recovery. 

Get Support, Community, Inspiration, Knowledge, and Skills.
Become a Partner in Recovery!

At Sexual Abuse Help you get each month new information, hot tips, interesting videos, and proven steps for your recovery.  These will come in the form of new pages or posts that you can access as often and for as long as you wish or need to. 

• You will learn how to create emotional safety
• You will discover easy techniques to keep healthy boundaries
• Develop strategies for distress tolerance
• Understand how sexual abuse has impacted on you
• Learn four effective steps for conflict management
• Discover how to communicate effectively
• Understand the need to stretch outside your comfort zone
• Develop skills for successful relationships
• Learn how to build a positive mindset
• Learn skills that increase your resilience to stress
• Discover an easy model to understand your reaction to others
• Find out how you can accurately determine how others treat you
• Develop your ability to identity dysfunctional dynamics
• Learn effective ways to stay out of dysfunctional dynamics
• Discover proven ways to increase your self-confidence
• Find ways of nurturing your creativity
• Connect with other survivors to give and receive support
• Learn about skills that help you with assertiveness
• Discover how to ask for your needs
• Find out that you are valued and appreciated by others

But we don’t just stop there. In Addition to all the resources listed above  – and you can be sure to get access to plenty of material, self-help exercises, and lots of eye-opening reading material – we have looked for other ways readers can connect with each other to give and get support. Check out our other amazing membership benefeatures:

• Every month you have the opportunity to receive a new episode of an audio-recovery-seminar with Dr. Gudrun Frerichs where we address a particular recovery issue and answer your burning questions about abuse and recovery that you can submit prior to recording. These seminars are recorded and you can download the MP3 file. These seminars start in October 2008.
• We have set up an art gallery. Our vision is that members use this feature to share and exhibit their artwork.
• We are also setting up a video gallery that features material from leading trauma specialists, selected videos from the internet, and videos produced by our very own members.

 One caution here: We will not ‘Do Therapy’.
This site is purely for support, help, information, and developing community.
That doesn’t mean being a part of the community and enjoying the connections and the benefits is not therapeutic. I guarantee it is! 

  The recovery from Childhood Sexual Abuse is a complex topic and many excellent writers have posted contributions that are well worth collecting and presenting as an ‘edition’ to those who are interested in learning more about the recovery from sexual abuse.

Contributions from survivors of sexual abuse, their own journey, their struggles in recovery, and their observations about what works and what doesn’t are just as valuable as the writings of professionals who often approach the recovery from sexual abuse from a slightly different angle.

This carnival is for both kinds of contributions. To spread the word, you can nominate an interesting post you have read somewhere or submit you own work. All contributions are welcome.

To submit an article / blogpost follow this link: http://blogcarnival.com/bc/submit_5111.html

Moving on from surviving sexual abuse to thriving in life can often be an up-hill battle of epic proportions. People, who have been sexually abused and did not get immediately support, care, and love from their parents, inevitably struggle with developing trust. This struggle is not a possibility, it is a fact. In most cases it is a direct result of the abuse. Being betrayed and abused by an adult who should care and protect erodes for most survivors the foundation for trust in other people. This is particularly bad when the perpetrator is a parent or close family member. Who can be trusted if the own family turns out to be not trustworthy?

Betrayal, breach of boundaries, and assault by an adult who is supposed to look after the child is an attack on her budding self-structures and that interferes with the child’s ability to develop a

• Sufficient level of self-confidence
• Sufficient level of regulating internal states
• Good enough thought processing networks
• Sufficient level of social functioning
• Healthy understanding of boundaries
• Basis level of trust and safety.

Instead, in an attempt to step away from people and thus from potential hurt, the child tries to maintain its internal equilibrium by resorting to withdrawal, avoidance, dissociation, or other socially isolating coping strategies.

Thus trauma not only attacks these self-structures and prevents normal functioning, the aftermath of trauma isolates the child and reduces opportunities to learn social skills or have experiences that could counteract the destruction of abuse.

 It’s no surprise then that starting therapy, meeting a potential life partner, having children, going to work, making friends all are activities that often cause a high level of fear, insecurity, and lead to great internal conflict.

In order to re-establish trust in other people, survivors of sexual abuse can help themselves by following some effective steps:

1. Start a journal and keep track of all interactions with others. Especially pay attention to any feelings that are familiar and remind you of the past. Write down your thoughts, memories, and feelings. Use the feeling as a bridge into the past that tries to let you know how it was for the younger you. You can use that information for processing some bits of the trauma. More important however is that you develop compassion with the younger you, the part of you that is reacts today with fear. 
2. When you are with another person and you get fearful, tell yourself that the feeling is most likely not about today, but it’s about the past. Kind of like an echo from the past that interferes with your life today. Always do the “Then-versus-Now-Test” and speak kindly to you younger parts.Allow your adult thinking to check out whether a present social situation is safe. If you conclude it is, stretch yourself and face the social situation. That might mean to connect with a therapist, friend, or partner.
3. You could have a little ‘training programme’ whereby you steadily increase the level of difficulty, frequency, or intensity of social contact.
4. Tell yourself that the feeling is a feeling from the past and therefore a cognitive distortion caused by the trauma. It was accurate in the past when you were traumatised, it’s an attribution error to have these feelings in present time.
5. It would be very good to address the struggle with trust regularly with your therapist. The more you can bring your feelings and the associated dynamics into awareness, the better you will deal with it.

Adults who suffer from the aftermath of sexual abuse often have their social avoidances strategies re-enforced over many decades. To reverse that will take time because it involves the building of new neuro-pathways that need to become ‘well trodden pathways’ through being used over and over again instead of the old, unhelpful ways of operating. This explains why the development of trust is a slow but steady process that takes time.

The alternative is rather sad. A person, who continuously gives in into her fear and responds to it with avoidance, will not have enough exposure to her upsetting material and desensitisation will occur only marginally. She will continue living with fear, flashbacks, distress, and isolation and re-enforce mal-adaptive behaviours. It could lead to chronically established psychiatric distress and condemn the survivor to live the life of a mental health patient.

Exercising the ‘trust-muscle’ ideally takes place in a relationship. That’s where many survivors of sexual abuse find themselves in a catch22. Having a lack of relationship skills often gets in the way of establishing and maintaining healthy relationships. When survivors have decides that they want to change this, they might benefit from learning a few simple relationship skills.

There are a number of ways survivors can go about learning these skills. One way is to enrole in my FREE mini e-course “The Secret To Successful Relationships”. Over 7 days you will receive an important lesson each day that will help you to get a head-start in relationships. If you want to find out how to build and maintain successful relationships send me an email to pgfrerichs@gmail.com.

I have been asked the other day whether people need to go to a psychotherapist or counsellor to recover from sexual abuse. I think that is a really good question. Does a person need therapy to heal? I don’t think it is necessary to go to a psychotherapist or counsellor. However, they need something because there is little evidence that people heal ‘naturally’ meaning by itself just through time passing.

What do survivors of sexual abuse need to recover? Human beings, like all mammals, depend on other’s to help regulate emotional and physical states. Babies depend completely on others for state regulation. Growing up people can do it more and more for themselves – if they have good enough caregiver/parents. However, people are never completely able to regulate their states by themselves. That’s where chat rooms, face book groups and other social networks on and off line are coming in. People need people who care, listen, understand, and are supportive.

Those who experienced abuse while growing up struggled to learn to regulate their emotional and physical states. The creation of the necessary the neuro pathways and cortical networks did not take place or only took place minimally. This is certainly the case if good enough parenting was a problem or if parents were also the abusers.

As a result here you are now, an adult, struggling with depression, anxiety, mistrust, phobias, flashbacks, physical flashbacks, to name a few of the disturbing symptoms. Needed is access to another person who understands, listens, cares, believes, challenges when necessary, to help establish the ability to self-regulate. Recognition given to the survivor in these forms enables them to build self-confidence and self-respect*. These are functions of the SELF that enable emotion regulation and distress tolerance.

People only get that form of recognition through another person. That can be a therapist, but doesn’t have to. It can be a friend, partner, or a group. It has to be someone who focuses fully or a lot on the survivor’s needs. What’s needed is someone, who through his/her actions affirms that the survivor is loveable, ok, gorgeous, cute, interesting, resourceful, clever, strong, or amazing. Such recognition will strengthen the survivor’s sense of self.

It is sad to realise how many survivors are on their recovery journey without support. That’s really a hard thing to have to do. The problem is if things take a long time and survivors don’t feel they are making any progress, they come to believe that they are un-helpable. They even might feel like giving up. That’s tragic!

A good therapist is able to make this journey much easier for survivors of sexual abuse. Having said that, the expression “good” doesn’t really refer to degrees or training or other achievements. A good therapist is someone who can establish a relationship with survivors. It is someone who is able to help survivors feel at ease and overcome the often deep seated mistrust.

Although a good therapist needs to know about sexual abuse and its impacts on survivors, most important is that he/she understands that survivors making a huge leap of faith by seeking help.This courage deserves highest respect.

*See PhD Thesis “Balancing Recognition and Disrespect: Recovery as the process of Identity Formation: A New Zealand Study of how Services shape the recovery from sexual abuse”. The thesis can be downloaded from the University Library (no costs are involved) by following the link AUT Scholarly Commons.