Body Experiences of Women Survivors of Child Sexual Abuse
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BODY EXPERIENCES OF WOMEN SURVIVORS OF CHILD SEXUAL ABUSE: IMPLICATIONS FOR THERAPEUTIC INTERVENTION Margit E. Asselstine A niesis submitted in confonnity with the requirements for the Degree of Doctor of Education. Graduate Department of Adult Education, Cornmunity Development, and Counselling Psychology University of Toronto @ Copyright by Margit E. Asselstine, 1997 Natianal tibrary Bibliothèque nationale I*l of Canada du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395. rue Wellington Ottawa ON KIA ON4 Ottawa ON K1A ON4 Canada Canada The author has granted a non- L'auteur a accordé une licence non exclusive licence allowing the exclusive permettant à la National Libmy of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or sell reproduire, prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/nlm, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette these. thesis nor substantial extracts fiom it Ni la thèse ni des extraits substantiels may be p~tedor othemise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. Body Experiences of Women Survivors of CMd Sexual Abuse: Implications for Therapeutic Intervention by Margit Asselstine A thesis submitted in conformity with the requirements for the degree of Doctor of Education, Graduate Department of Adult Education, Cornmunity Development, and Counselling Psychology, University of Toronto, 1997. ABSTRACT Previous research identifies the impact of child sexual abuse on a child's cognitive and emotional orientation to the world but has neglected to include its impact on the child's physical orientation to the wodd. Conventional psychotherapeutic practice has few if any techniques for including the physical dimension within verbal exploration and integration. Research, however, continues to show the necessity for a non-intellectual approach for accessing state-bound information for the purpose of traumatic mernory retrieval and integration. The intention of this study was to explore the body experiences of women survivors within a verbal body-focused intervention that did not involve touch or movement therapy. This study demonstrates that the body is closely and inexûicably involved when trauma is experienced, particularly in childhood sema1 abuse. Five women survivors of child sexual abuse, al1 of whom were currently in psychotherapy, participated in one body-focused verbal experiential session. The session was followed by two interviews one week and one year Iater to discuss and evaluate their body- oriented experience and its relationship to their healing process. An interna1 focus on their body experience created a non-ordinary state in which the body could speak from its own perspective without the filter of the intellect. Following the sensation of a memory led the participants either to a memory of the abuse itself or to an unresolved related issue. The iii results ïndicate that a variety of kinaesthetic experiences are part of the memory of trauma. including the trauma of immobilization and the feeling of being physically trapped in terror, body disruptions that involve the rnind "splittïng" from the body, and the "splitting" of body areas that represent separated parts of self with diffe~gperspectives on the trauma. Following the sensation of a memory and incorporating psyche-soma linking led the participants to a changed and more integrated relationship with their body. Body-oriented memory retrieval and integration, and the intemalization of the process of dialogue with their body 1ed these women to new opportunities for healing that would not have been available otherwise. TABLE OF CONTENTS Abs tract List of Figures List of Appendices Acknowledgements 1. INTRODUCTION 1.1 . Overview ..................................... 1 1.2. Locating Myself as a Researcher ........................... .. .. 2 1.2.1. My Personal Evolution ................................ 2 1.2.2. Evolving a Research Topic .............................. 6 1.2.3. Rationale for the Study ................................ 8 2 . LITERATURE REVIEW 2.1. Theories Relating Psyche and Soma ............................ 13 2.2. The Effects of Child Sexual Abuse ............................ 17 2.3. Trauma and Memory ..................................... 24 2.3.1. How Children Remernber .............................. 24 2.3 .2. Myths and Misconceptions about Reality Versus Fantasy ........... 26 2.3.3 . Accessibility of Traumatic Memories ....................... 27 2.3.4 . Trauma and the Body Experience ......................... 30 2.3.5. The Relevance of State Dependency ....................... 34 2.3.6. Intervention .................................... 39 V 3 . RESEARCH OBJECTIVES AND METHOD 3.1. Research Objectives and Research Questions ....................... 47 3.2. The Development of a Body-Focused Psychotherapeutic Intervention Technique . 48 3.2.2. Finding a Conceptual Framework ......................... 49 3 .2.3. Finding a Body Base ................................. 51 3.2.4. Acknowledging the Therapy Relationship .................... 52 3 .2.5. Understanding the Experiential Session ...................... 55 3.2.6. Continuous Body-Refocusing Facilitates Psyche-Soma Linking ....... 59 3.2 .7 . Approaches to the Inclusion of the Body in Related Therapy ......... 60 4 . METHODOLOGY 4.1. Adopting a Heuristic Approach ............................... 63 4.2. Women's Personal Experience of Their Body: A Case Study ............. 65 4.3. TheShxdy .................................... 68 4.3.1. Women Survivors of Child Sexual Abuse: The Research Participants ... 68 4.3.2 . The Role of the ResearchedFacilitator: Engaging in the ........... 69 Therapeutic Process 4.3.3. Four Data Collection Phases ........................... 71 4.3.4. Qualitative Data Analysis : Creating Stories ................... 75 4.3.5. Beuig Informed by the Pilot Smdy ........................ 76 CASE STUDIES OF FIVE WOMEN'S EXPERIENTIAL SESSIONS: FESEARCH FINDINGS Organization of the Findings ................................ 79 Mary's Session .................................... 80 Gwen's Session ................................... 94 Willo 's Session .................................... 108 Trudi's Session ....................................122 Laura's Session .................................... 137 THOUGHTS. REFLECTIONS AND INSIGHTS RELATED TO THE EXPERIENTIAL SESSIONS: RESEARCH FINDINGS The Healhg Process .................................... 149 6.1.1. Individual Modalities for Entry to the Body Expenence ........... 150 6.1.2. The Head-Body Split and Betrayal by the Body ................ 153 6.1.3. Body Parts in Dialogue. Psyche-Soma Linking. Iritegrating ......... 159 the Hurt Child. and Creating Healing hagery 6.1.4. New Self-Care Strategies and Tools ....................... 171 Participants' Evaluations .......................... ......... 184 6.2.1. A Process Not Dorninated by the Intellect Facilitates Integration ...... 185 6.2.2. The Session Facilitates Memory Recall and Retrieval of Images ....... 187 that Would Not Have Happened Otherwise 6.2.3. A Flexible Physical Environment Provides Opportunities to ......... 190 Explore Body Processes 6.2.4. A Therapeutic Relationship of Trust. Safety. and Gentleness and the .... 191 htemalization of the Therapist's Trust in the Process 1s Helpful vii 6.2.5. A Self-Directed Pace Ailows Full Processing of the Material as It ..... 193 Ernerges and Avoids " Flooding " and Dissociation 6.2.6. The Use of a Body-Focused Approach Without Physical Touch ....194 b y the Therapist Facilitates Integration 6.2.7. Drawing a Picture at the End of the Experiential Session ......... 198 Contributes an Additional Elernent to the Healing Process 7. DISCUSSION 7.1. Body Experiences of Women Survivors of Child Sexual Abuse: ........... 201 Refiections on the Findings 7.2. Implications for Therapeutic Intervention ......................... 219 7 .3. Implications for Future Research .............................. 222 7.4. Limitations of the Study ................................... 225 7 .5 . Conclusion .................................... 227 References .................................... 228 viii LET OF FTGURES Mary's Drawing ................................... 93 Gwen's Drawing ................................... 107 Willo's Drawing ................................... 121 Trudi's Drawing ................................... 136 Laura's Drawing ................................... 147 LIST OF APPENDICES Appendix A Letter of Informed Choice .............................233 Appendix B Background Information Sheet ........................... 235 Appendix C Interview Schedule The Experiential Session ...................... 238 Appendix D Interview Schedule Follow-Up Interview One Week Later ...........242 Appendix E Interview Schedule Follow-Up Interview One Year Later .................. 243 ACKNOWLEDGEMENTS To begin I would like to acknowledge the women survivors who so wiliingly gave their rime to this project. Their sharing of experiences and insights so that others may lem from them is greatly appreciated. A special thank you to Dr. Niva Piran for her encouragement to pursue this topic and her guidance during the course