We Are Survivors 

This blog is dedicated to the tens of millions of adult survivors of child abuse and neglect who get up every day and try to work and function in a world that seems to not care about us.

Adult Survivors' Control Issues

Many survivors have emailed me about their inability to get their needs met within relationships. When expectations are not met, they would rather isolate than be subjected to anymore rejection from others, which is only natural. We as survivors feel angry, depressed, and are at our wits end because we want to have more control over our lives but can’t seem to make that happen.

Child Abuse Triggers & Dissociation - Part 3

To better understand how to respond to someone who has dissociated, it is helpful to know what dissociation looks like and how to assist someone in that state. The following responses are examples of dissociation[1]:

Child Abuse Triggers & Dissociation - Part 2

Clinical practice incorporates many experiences in addition to touch that may trigger a negative response in a survivor even though they seem innocuous to the clinician.[1] Survivors have described triggers such as the use of water, ice, traction, or ultrasound gel. They also spoke about medical procedures and treatments during which they had to remain immobile or silent or heard others crying out with pain or anxiety, reminding them of abuse experiences.

Child Abuse Triggers & Dissociation – Part 1

A trigger is anything (e.g., a sight, sound, smell, touch, taste or thought) associated with a past negative event that activates a memory, flashback or strong emotion. Because triggers are directly associated with a particular event or events, they are unique to each individual. That explains why different stimuli will trigger different people; and why a therapist can never remove or avoid every potential trigger in a practice setting.[1]

Therapy Issues For Survivors – Part 3

This is the third of a series in discussing effective treatment for adult survivors of child abuse and neglect who are diagnosed with depression, PTSD, and DID. Therapy is very complex.

Therapy Issues For Survivors – Part 2

This is the second part in a series of discussing effective treatment for adult survivors of child abuse and neglect. This three-stage approach has been shown to be very helpful when working with clients diagnosed with depression, PTSD, and DID.

Therapy Issues For Survivors – Part 1

Over the years, I have gotten a lot of emails asking for information about effective therapy for adult survivors of child abuse and neglect. I am not a clinician, however, after successfully completing 23 years of therapy to recover from Major Depression, PTSD, and Dissociative Identity Disorder or DID (I integrated about 20 alters), as well as conducting in depth research over the past 30 years, I have a very good grasp of the issues and first-hand knowledge of what it takes to recover. That said, I am writing a series of articles about what I believe are key issues in the treatment of survivors.

Cycle of Traumatic Reenactment

When I was struggling with one crisis after another in therapy, trying to get my life back on track, there always seemed to be something that would happen to upset me. When that happened, I reverted back to my old ways of coping (isolation and binge eating) until I felt calmer and could function better. It seemed like a never-ending cycle – and it was.

Best Way to Work with Survivors - Part 2 of 2

This blog is a continuation of Blue Knot Foundation's literature review [1] of best approaches to working with adult survivors of child abuse and neglect. Anyone working with survivors are encouraged to read both posts (Best Way to Work with Survivors - Part 1).

Best Way to Work with Survivors - Part 1 of 2

The Blue Knot Foundation, formerly known as ASCA (Adults Surviving Child Abuse) did an extensive literature review on the needs of adult survivors of child abuse and neglect.[1] The following principles are important and should be incorporated into standard practice guidelines for professionals working with adult survivors.

Long-Term Sexual Impact of Child Abuse

There have been many studies documenting the effect child abuse has on many women’s sexual activity later in life. Naturally, these problems impact a woman’s ability to sustain a loving, long-term, intimate relationship.

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Understanding Emotional Abuse

The foundations for good mental health are laid down in the emotional development that occurs in infancy and later in childhood. When a child experiences a warm, intimate and continuous relationship with his/her mother or other caregiver, that child will grow and thrive. On the other hand, an unresponsive parent, or one who responds inappropriately to a child’s needs,  will increase the likelihood of the child becoming anxious and insecure in its attachment.

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Healing From Posttraumatic Stress Disorder

To have one’s inner sense of security shattered, particularly at a young age, disrupts people’s perception of a safe world. “A lack of predictability and controllability are the central issues for the development and maintenance of Posttraumatic Stress Disorder (PTSD)[1]. The intrusiveness of the memories of past trauma appears to orient people toward doing their best to numb their feelings, to get away from those awful remembrances. I experienced this as I became more in touch with memoires of my own childhood abuse. I paid attention to and learned that I was shutting down my feelings, overeating to self-medicate or numb out, and dissociating to escape my traumatic feelings.

Survivors Learning Healthy Control

When growing up in an abusive environment, control becomes an important issue. Clearly, in the beginning, control rests with the abusive parents/caretakers, so children will adapt to their environment the best way they can. In the process, however, children become very attuned to high levels of stress—so much so that their autonomic nervous system is affected. They develop strong reactions to even relatively low levels of stress, and then it takes longer than normal to return to a restful state.

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Survivors Healing from Reactive Behaviors

One of the issues I dealt with in my therapy was I knew I sometimes exhibited childlike behaviors that were irrational, but I didn’t understand why that continued to happen. As an adult, I observed my behaviors and wanted to change them. It wasn’t until I understood the application of “introjects” that I could begin turning those behaviors around.

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Long-Term Effects of Child Sexual Abuse

 If a survivor of child sexual abuse has not been in therapy or been helped along the way to cope with his/her abuse history, there is a range of effects that stem from the abuse. Depending upon each individual survivor’s trauma history, the following list provides the common effects many survivors must deal with as a result of their abuse.

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Survivors Using Self-Injury To Cope

The first time I met someone who used self-injury to cope with her distress was during one of my hospitalizations. I felt very sad for her because I understood the depth of the pain she must have been dealing with and how desperate she must have felt. I did some research to try and understand this coping mechanism and found that the root causes were very similar to the reasons why many of us develop other self-defeating behaviors as a result of being abused such as binge eating, prostitution, and drug abuse.

Dependency Issues with Therapists

One of the most difficult issues to deal with in therapy is dependency – a state of mind where we are supposed to rely on someone for aid and support – our therapist. Our deepest wounds, though, were inflicted upon us when we were the most vulnerable: when we were loving, trusting, and emotionally available children. As adults, we tell ourselves at some level that that will never happen again.

Reversing Destructive Patterns

Many survivors have an ongoing problem with regulating their feelings and the self-harm that follows. This includes everything from eating disorders, substance abuse, self-mutilation, and, at times, thoughts of suicide. It might be helpful to understand the cycle that occurs that works to perpetuate these destructive patterns so that changes can be made.

Physical/Sexual Abuse Treatment Principles

Child victims of physical or sexual abuse very often have complicated histories of multiple victimization and trauma, and exhibit a variety of disorders, problems, and difficulties that may or may not be the direct result of abuse. Although the following list of treatment guidelines pertains to children in treatment for abuse,[1]it is helpful for adults as well. Some of the work that needs to be done in therapy is described below such as:

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