SEXUAL ABUSE TEXAS FAMILY CODE • SEXUAL ABUSE INCLUDES THE FOLLOWING ACTS OR OMISSIONS BY ANY PERSON: THE ASSESSMENT AND TREATMENT SEXUAL CONTACT, SEXUAL INTERCOURSE, OR OF SEXUAL ABUSE SEXUAL CONDUCT, AS THOSE TERMS ARE DEFINED BY SECTION 43.01, PENAL CODE, SEXUAL PENETRATION WITH A FOREIGN BY OBJECT, INCEST, SEXUAL ASSAULT OR SODOMY MARIA T. MOLETT, MA, LPCS, LSOTPS INFLICTED ON, SHOWN TO OR INTENTIONALLY PRACTICED IN THE PRESENCE OF A CHILD IF THE CHILD IS PRESENT ONLY TO AROUSE OR FEBRUARY 6, 2012 GRATIFY THE SEXUAL DESIRES OF ANY PERSON;

FAILURE TO MAKE A REASONABLE EFFORT TO PREVENT THE SEXUAL ABUSE BY ANOTHER PERSON; CHILD SEXUAL ABUSE OCCURS WHEN A CHILD IS USED AS AN OBJECT FOR THE COMPELLING OR ENCOURAGING A CHILD TO SEXUAL GRATIFICATION OF AN ADULT ENGAGE IN SEXUAL CONDUCT; OR THROUGH MANIPULATION, EXPLOITATION, CAUSING, PERMITTING, ENCOURAGING, ENGAGING THREATS, OR PHYSICAL FORCE; OR A MINOR, IN, OR ALLOWING THE PHOTOGRAPHING, FILMING, UNDER 18 YEARS OLD WHO IS TAKING ON OR DEPICTING OF THE CHILD IF THE PERSON KNEW THE PARENTAL ROLE, AS IN BABYSITTING. OR SHOULD HAVE KNOWN THAT THE RESULTING PHOTOGRAPH, FILM, OR DEPICTION OF THE CHILD IS OBSCENCE OR PORNOGRAPHIC COOPERATION IS NOT CONSENT

SEXUAL ABUSE IS ANYTHING SEXUAL WITH A HISTORY AND STATISTICS CHILD WHERE THE INTENT IS TO SEXUALLY AROUSE OR CONTROL THE CHILD. IT CAN BE • SEXUAL ABUSE HAS BEEN IN EXISTENCE CONFUSING, VAGUE ARRAY OF SEXUAL FOREVER INTERACTIONS WITH HUNDREDS OF PRIVATE • CROSSES ALL BOUNDARIES: RACE, MEANINGS ON ONE END OF THE CONTINUUM CULTURE, EDUCATION AND ECONOMIC TO INTERCOURSE ON THE OTHER END. IT’S • 1 OUT OF 4 FEMALES FRENCH KISSING, INAPPROPRIATE • 1 OUT OF 5 MALES TOUCHING DURING BATHING OR CHANGING OF CLOTHES, ALLOWING CHILDREN TO SEE • ALL SEXUAL ABUSE IS GREATLY UNDER PARENTS MAKING LOVE, NUDITY, ORAL SEX, REPORTED FONDLY, PORNOGRAPHY,ETC.

1 REASONS FOR UNDER REPORTING TEXAS LAW

• LACK OF KNOWLEDGE AS TO LACK OF • ALL ADULTS, TEACHERS, PRINCIPALS, DOCTORS, RECOGNITION OF THE PHENOMENON BY NURSES, LAW ENFORCEMENT, COUNSELORS, PROFESSIONALS CLERGY, PARENTS, RECREATION WORKER • HOW TO RECOGNIZE AND TREAT • FAILURE TO OBTAIN ADEQUATE MEDICAL CORROBORATION • CRIME IF UNREPORTED • RELUCTANCE OF THE VICTIMS TO REPORT • INFREQUENT ENFORCEMENT AND SMALL PENALTIES

PROBLEMS KEY FACTOR IN SECRECY

• 1990 RAND CORP. SURVEY FOUND 40% OF • 90% OF THE OFFENDERS ARE FAMILY PROFESSIONALS ADMITTED THEY HAD NOT REPORTED AT LEASE ONE INSTANCE OF MEMBERS OR TRUSTED FRIENDS OF SUSPECTED ABUSE THE FAMILY • 2008 STUDY PUBLISHED IN THE JOURNAL OF • VICTIMS ARE MADE TO FEEL IT IS PEDIATRICS, NOT REPORTED ABUSE BECAUSE OF UNCERTAINITY AND WORRY THAT REPORT WOULD THEIR FAULT DO MORE HARM THAN GOOD • VICTIMS BELIEVE THAT THERE IS NOTHING THAT THEY CAN DO ABOUT THE ABUSE

PHILOSOPHY OF TREATMENT

• SURVIVOR ORIENTED THERAPY SPECIFICALLY FOCUSES ON THE ORIGINAL ABUSE AS ONE OF THE KEY ISSUES IN PRESENTING PROBLEM TREATMENT, RELATING THIS EARLY TRAUMA TO LATER AND CURRENT THIS IS TYPICALLY NOT SEX ABUSE EXPERIENCES AND BEHAVIOR THEREFORE, INTAKE PREOCEDURES MUST EVALUATE SEXUAL ABUSE HISTORY

2 THERE ARE NO CRITERIA TO DETERMINE DEVELOPMENTAL TRIGGER HOW EACH PERSON WILL REACT TO SEXUAL ABUSE • THIS IS ANY DEVELOPMENTAL MILESTONE THAT • SOME VICTIMS’ PERSONALITY MAY BE CAUSED A NEGATIVE EFFECT OF SEXUAL ABUSE PLASTIC AND HIGHLY ADAPTIVE, WITHOUT TO EMERGE AFTER SOME PERIOD HAS ELAPSED INDICATION OF TRAUMA SINCE THE SEXUAL ABUSE STOPPED.

– PUBERTY, INTIMATE RELATIONSHIP, MARRIAGE, • SOME BECAUSE OF FAMILY PATHOLOGY DEATH OF THE OFFENDER, BIRTH OF A CHILD HAVE THE TRAUMA CARRY OVER INTO THEIR ADULT LIFE AND FAMILY RECREATING THE DYSFUNCTION

EVALUATE THE DEGREE OF NEGATIVE FORMAL EVALUATION EFFECT • ONSET & LENGTH OF • NUMBER OF • CLINICAL INTERVIEW ABUSE OFFENDERS • MENTAL & EMOTIONAL • SUPPORT FOR THE • REVIEW OF CPS, POLICE RECORDS HEALTH OF VICTIM VICTIM • DIAGNOSTIC TOOLS • TYPE OF ABUSE • THREATS AND • PSYCHIATRIC REFERRAL • RELATIONSHIP OF THE VIOLENCE OFFENDER • THERAPY OR NO • MEDICATION OR HOSPITALIZATION • SECRECY, DUPLICITY THERAPY AND SILENCE LEAD TO • OTHER ISSUES ISOLATION, AND IMPACTING VICTIM AND SELF-ESTEEM OR FAMILY

SYMPTOMS BEHAVIORAL CLUES IN CHILDREN….

• SLEEP DISTURBANCES • PHOBIAS • BEDWETTING • EATING DISORDERS • DRESSING SEDUCTIVELY • STOMACH PAIN • OVER DRESSING • ENURESIS, ENCOPRESIS • VENEREAL DISEASE • DEPRESSION • PROMISCUITY • REGRESSIVE BEHAVIORS • LOW SELF-ESTEEM • PREGNANCY • POOR SCHOOL • PROSTITUTION PERFORMANCE • SUICIDE • FIRE SETTING • SUBSTANCE ABUSE • DISSOCIATIVE DISORDER • RUNNING AWAY • NONE OF THE ABOVE!!! • DELINQUENT BEHAVIOR • CRUELTY TO ANIMALS

3 THE KILLING AND TORTURING OF ANIMALS IS A SIGNIFICANT CRY FOR HELP MASTURBATION IN CHILDREN

• THE CHILD IS BEHAVIORALLY RE-ENACTING • SEXUALIZED CHILDREN SHOW THEIR OWN ABUSE ON A SMALLER VICTIM DISINHIBITION OF MASTURBATORY BEHAVIOR • A CHILD WHO HAS NOT BEEN SEXUALLY • THE CHILD IS REHEARSING SUICIDE ABUSED WILL ABRUPTLY STOP MASTURBATING WHEN SOMEONE ENTERS • THE STRONGER THE CHILD’S EMOTIONAL THE ROOM ATTACHMENT TO THE ANIMAL, THE MORE • THERAPIST MUST SET AND ENFORCE ALARMING THIS BEHAVIOR LIMITS THAT PARENTS MUST ALSO ENFORCE; SUGGEST ALTERNATIVE BEHAVIOR

TYPES OF DISCLOSURE

• INTENTIONAL IT IS NOT UNUSUAL FOR A CHILD, ADOLESCENT OR ADULT TO • UNINTENTIONAL RECANT THE DISCLOSURE.

PRESSURE FROM FAMILY, SAFETY ISSUES, GUILT, • ACCIDENTAL

VIDEO Stories No One Wants to Hear 28 minutes THERAPIST QUALITIES

• ADMIT THAT SEX ABUSE EXIST • BE ABLE TO ASK DIRECT QUESTIONS • EXAMINE THEIR OWN BELIEFS ABOUT SEX ABUSE AND WHAT IS NORMAL, MYTHS, ETC. • RULE OF SECRECY- DO NOT KEEP IT!!! • BE WILLING TO TALK FRANKLY AND USE CLIENT’S WORDS • BE FAMILIAR WITH SEX ABUSE LIFE PATTERNS-BE CLINICALLY PARANOID • BE IN TOUCH WITH YOUR OWN FEELINGS AND IF YOU HAVE TRUAMA IN YOUR PAST, GET IT TAKEN CARE OF

4 THERAPIST QUALITIES ASSISTING DISCLOSURE

• JOIN A SUPPORT GROUP OF OTHER • ASK DIRECTLY IF SEXUAL ABUSE OCCURRED THERAPISTS TO DEAL WITH SECONDARY DURING CHILDHOOD POST-TRAUMATIC STRESS DISORDER • IF CHILD, ESTABLISH RAPPORT IN A STRUCTURED ENVIRONMENT FIRST • READ, READ, READ PROFESSIONAL • USE A STRUCTURED QUESTIONAIRE SUCH AS AN MATERIAL AS WELL AS MATERIAL WRITTEN INTAKE AND DO A GENOGRAM BY VICTIMS • EXPLORE SYMPTOMS THAT ARE TYPICAL OF SEX • ATTEND A VICTIM’S PANEL ABUSE • ATTEND TRAININGS • DEFINE SEX ABUSE TO THE CLIENT/PARENT • BE PERSISTENT IN PROBING BUT DO NOT LEAD

THERAPIST NEED TO REASSURE THE ONCE DISCLOSURE TAKES PLACE… CLIENT….

• REPORT TO APPROPRIATE AGENCY • CLIENT WILL BE BELIEVED AND NOT BLAMED • IDENTIFY SEX ABUSE AS PRIMARY CAUSE OF • RESPONSIBILITY FOR THE ABUSE BELONGS TO CLIENT’S DIFFICULTIES THE OFFENDER • ACKNOWLEDGE AND VALIDATE SIGNIFICANCE OF • CLIENT DID THE BEST THEY COULD HAVE DONE TO ABUSE SURVIVE • RELATE SPECIFIC DIFFICULTIES IN CLIENT’S LIFE • AS CHILDREN, CLIENTS WERE NOT IN CONTROL OF TO COPING SKILLS DEVELOPED TO SURVIVE THE SITUATION • DO NOT MINIMIZE SEX ABUSE EVEN IF IT • DETAILS OF THE COUNSELING WILL BE OCCURRED ONE TIME CONFIDENTIAL, WITH CERTAIN EXCEPTIONS • ENCOURAGE CLIENTS TO WORK ON THE SEX • CLIENTS ARE SURVIVORS AND CAN AND DO ABUSE RECOVER

• CLIENTS CAN GET OVER THEIR FEELINGS TREATMENT INTERVENTIONS OF SHAME

• THERAPIST’S FEELINGS TOWARDS THE • EVALUATE THE SITUATION- MAY NOT BE ABUSE CLIENT WILL NOT CHANGE AS A RESULT OF HEARING ABOUT THE ABUSE • PREVENT FURTHER ABUSE • STABILIZE THE SITUATION • PROVIDE THERAPY – INDIVIDUAL, NON-OFFENDING PARENT, SIBLING, – PLAY THERAPY – VICTIM’S GROUP, PARENT GROUP – FAMILY, MARITAL – OFFENDER/VICTIM, OFFENDER TREATMENT

5 PLAY THERAPY TECHNIQUES….

• DONE ONLY AFTER ABUSE HAS BEEN • ESTABLISH • WRITING EXERCIES REPORTED OR IF ABUSE IS NOT RAPPORT • EDUCATION OF REPORTABLE OR CAN NOT BE ACTED ON • ANATOMICAL CHILD AND PARENT DRAWINGS • SUPPORT GROUP • EVALUATION TO INCLUDE FAMILY AND • THERAPEUTIC FOR PARENTS COLLATERAL INFORMATION FROM CHILD’S DRAWINGS • INDIVIDUAL, FAMILY SYSTEM • ANATOMICAL AND GROUP DOLLS THERAPY • CONFIDENTIALITY AND REPORTING LAW

MATERIALS USED IN ASSESSING WRITING EXERCISE… CHILDREN

Letter to the offender • PUPPETS • ANATOMICAL DOLLS Letter to the child who was victimized • DRAWINGS • DOLL HOUSES, TELEPHONE Who I am today • PREVENTION BOOKS FILMS • FACES (SAD, MAD, GLAD, ETC.) Letter to other survivors • SAND TRAY

A COMMON DANGER IS TO MOVE FASTER SECRECY….. THAN THE CLIENT IS ABLE TO FOLLOW

• ABUSERS KNOW HOW TO TRICK AND • RESPECT THE CLIENT’S NEED TO MANIPULATE CHILDREN AND PARENTS REGULATE THE FLOW OF THERAPY • THIS MUST BE ADDRESSED IN • SINCE SEXUAL ABUSE OCCURS IN A CONTEXT OF POWERLESSNESS, EDUCATION AND THERAPY INTRUSION AND AUTHORITARIANISM THE – GOOD VS BAD SECRET THERAPY MUST REMEDY THE EFFECTS OF – SAFE PEOPLE TO TELL SUCH DYNAMICS NOT RECAPITULATE THEM – NO OR REJECTION

6 NINE AREAS TO BE ASSESSED…

• GUILT • REPRESSED & HOSTILTIY ABUSE FOCUSED THERAPY IS MOST • FEAR SUCCESSFUL WHEN IT FOSTERS A • INABILITY TO RELATIVELY EGALITARIAN ATMOSPHERE, • DEPRESSION WHERE THE CLIENT IS SEEN AS AN EQUAL • ROLE CONFUSION PARTNER IN TREATMENT • LOW SELF-ESTEEM • PSEUDO MATURITY • POOR SOCIAL SKILLS • SELF MASTERY/ CONTROL

THERAPIST NEED TO ENCOURAGE AND VALIDATE THAT…

• CLIENTS MAY TEMPORARILY FEEL WORSE BEFORE THEY FEEL BETTER • CLIENTS HAVE A RIGHT TO FEEL ANGER AND GRIEF • CLIENTS HAVE A RIGHT TO HAVE POSITIVE FEELINGS TOWARDS THE OFFENDER EMPOWER THE VICTIM • CLIENTS DID NOT DESERVE THE ABUSE • CLIENTS ARE MAKING GAINS DESPITE HOW SMALL THEY SEEM • COPING MECHANISMS ARE SEEN AS “SURVIVOR SKILLS” AND ADAPTIVE

PROCESS OF THERAPY MALE AND FEMALE DIFFERENCES

• METAPHOR FOR THE THERAPY • EXPRESSION OF TRAUMA • WORK NEEDS TO BE FLEXIBLE • MANNER IN WHICH DISCLOSURE TAKES PLACE – TYPE, DURATION, “VACATIONS”, HOSPITALIZATIONS • EMPOWERMENT ISSUES – COORDINATION OF SERVICES WITH • MANY SIMILARITIES PSYCHIATRIST IS NECESSARY FOR CLIENTS ON MEDICATIONS – COURT CASES, COORDINATION WITH ATTORNEYS, PREPARATION FOR COURT

7 VIDEO FOUR KINDS OF PSYCHOLOGICAL EFFECTS MALE VICTIMS’ GROUP THAT ARE THE RESULTS OF SEXUAL 35 minutes VICTIMIZATION • POST TRAUMATIC STRESS DISORDER

• COGNITIVE EFFECTS

• EMOTIONAL EFFECTS

• INTERPERSONAL EFFECTS

POST TRAUMATIC STRESS DISORDER • A WIDE VARIETY OF OTHER REACTIONS OR PTSD SYMPTOMS SUCH AS SLEEP DISTURBANCE, DIFFICULTY CONCENTRATING, MEMORY • REFERS TO THE PSYCHOLOGICAL REACTIONS OF THE SURVIVORS ACCORDING TO THE DSMR PROBLEMS, IRRATIONAL GUILT, EXTREME – PSYCHOLOGICALLY DISTRESSING EVENT LIKE SEXUAL ALERTNESS TO DANGER IN THE ABUSE CAN PRODUCE EITHER CHRONIC OR DELAYED ENVIRONMENT, AND AN INTENSIFICATION PTSD OF SYMPTOMS UPON EXPOSURE TO – REEXPERIENCING THE TRAUMA THROUGH DREAMS OR FLASHBACKS SITUATIONS THAT RESEMBLE THE – NUMBING OF GENERAL RESPONSIVENESS TO OR ORIGINAL TRAUMATIC EVENT AVOIDANCE OF THE EXTERNAL WORLD • TRIGGER, CAN INVOLVE ALL THE SENSES (DISSOCIATION, WITHDRAWAL, RESTRICTED AFFECT OR LOSS OF INTEREST IN DAILY EVENTS AND MAY LOOK LIKE HALLUCINATIONS

DISSOCIATION SYMPTOMS…

DISSOCIATION: A DISTURBANCE • SPACING OUT OR ALTERATION IN THE NORMALLY • DEREALIZATION: THE EXPERIENCE THAT INTEGRATIVE FUNCTIONS OF THINGS AROUND ONE ARE FALSE OR IDENTITY, MEMORY, OR UNREAL CONSCIOUSNESS. THIS MAY BE • DEPERSONALIZATION: THE SENSE THAT ONE IS DIFFERENT FROM ONE’S SELF SUDDEN OR GRADUAL, TRANSIENT • OUT OF BODY EXPERIENCES: SENSATION OR CHRONIC. OF FLOATING OUTSIDE OF ONE’S BODY AND TRAVELING ELSEWHERE

8 • BLANKS IN MEMORY TECHNIQUES FOR ADDRESSING DISSOCIATION • MULTIPLE PERSONALITIES • DEVELOP A • UNDERSTAND LANGUAGE PRECIPITANTS • ASSESS PATTERNS • ADDRESS THE OF USE TROUBLESOME • HELP DETERMINE EMOTION DISSOCIATIVE • GIVE SEQUENCING ALTERNATIVES TO • EXPLAIN IT AS THE FLIGHT ADAPTIVE RESPONSE

COGNITIVE EFFECTS COGNITIVE CHANGES….

• ABUSE CAN PRODUCE NEGATIVE CHANGES IN THE • NEGATIVE SELF-EVALUATION AND GUILT WAY IN WHICH THE VICTIM PERCEIVES AND (SEE SELF AS BAD, EVIL, RESPONSIBLE UNDERSTANDS THEMSELVES, OTHERS AND THE FOR THEIR OWN PAIN) FUTURE • PERCEIVED HELPLESSNESS AND • SUCH ALTERED BELIEFS AND PERCEPTIONS ARE HOPLESSNESS BECAUSE OF LOSS OF OFTEN LONG-STANDING AND RELATE TO THINKING CHOICE. VICTIM FEELS POWERLESS AS OPPOSED TO FEELING • DISTRUST OF OTHERS • EMOTIONAL EFFECTS-ANXIETY, DEPRESSION

• INTERPERSONAL EFFECTS- FROM THEIR ABUSE CHILDREN LEARN CERTAIN PATTERNS OF REVICTIMIZATION BEHAVIOR THAT ARE HARMFUL TO THEMSELVES OR OTHERS, OR THAT RESTRICT THEIR DEVELOPMENT AND PREVENT THEM FROM • WHY? VICTIMS SEE “MEN” IN A POSITIVE LIGHT MAY OVERLOOK CUES OR BEHAVIORS THAT ATTAINING ADEQUATE FUNCTIONING. THESE NONABUSED INDIVIDUALS WOULD SEE AS DANGER EFFECTS ARE ASSOCIATED WITH FEELINGS OF: SIGNS • WHEN CONFRONTED WITH ABUSIVE BEHAVIOR – ALIENATION, CHRONIC NEEDINESS, ANGER, RAGE, THE SURVIVOR MAY BE MORE PRONE TO FEARFULLNESS “FORGIVE AND FORGET”. HOPE THAT CURRENT ABUSER WILL REDEEM THEMSELVES IN WAYS THAT THE ORIGINAL ABUSER DID NOT • THE SURVIVOR’S LOW SELF-ESTEEM AND SELF- PUNITIVENESS MAY ATTRACT HER TO ABUSIVE INDIVIDUALS

9 -THE LEARNED HELPLESSNESS ARISING FROM SEXUAL ABUSE MAY CREATE VICTIMS WHO BECOME COMPULSIVE SEXUALITY PASSIVE IN THE FACE OF IMPENDING VICTIMIZATION • SURVIVOR FEARS THE VULNERABILITY AND -ABUSIVE MEN AND WOMEN MAY LEARN TO INTIMACY INHERENT IN SEXUAL RELATIONSHIPS. IDENTIFY OTHERS WHO HAVE BEEN PREVIOUSLY • THIS MAY LEAD TO SEXUAL DYSFUNCTION, ABUSED AND THUS ARE EASY PREY DISSOCIATION, AND/OR DISTRUST OF SEX PARTNERS AND MEN OR WOMEN IN GENERAL • SURVIVOR LONGS FOR NURTURANCE AND CARE THEY DID NOT RECEIVE IN CHILDHOOD, THEY LEARNED THAT THEIR MOST POWERFUL ASSETS IN GAINING CONTACT OR CONTROL WAS THEIR SEXUAL AVAILABILITY, THEY ENGAGE IN PROMISCUITY OR COMPULSIVE SEXUAL BEHAVIOR

MANIPULATION ACTING-OUT AND ACTING-IN

• THIS IS A SURVIVAL TECHNIQUE BASED ON • ACTING-OUT: ACTS THAT ARE SELF- SEVERAL UNDERLYING DYNAMICS: DESTRUCTIVE OR HARMFUL TO OTHERS AND THAT ARE THOUGHT TO ARISE FROM • LOW SELF-ESTEEM INTERNAL CONFLICT

• THE SURVIVOR’S THAT NOTHING GOOD IS FREELY GIVEN • ACTING-IN: SURVIVOR TURNS CONFLICT INWARD, PUNISHING SELF RATHER THAN • THEIR PREVIOUSLY DEVELOPED SKILLS AT OTHERS FOR ABUSE RELATED PAIN EXTRACTING NEEDED RESOURCES FROM A HOSTILE ENVIRNOMENT

EXAMPLES….. SELF-MUTILATION

• TRUANCY • DRUG & ALCOHOL • THIS IS A WAY TO TERMINATE DISSOCIATIVE EPISODES • SCHOOL PROBLEMS • SELF-MUTILATION • DISTRACT ONESELF FROM PAINFUL MEMORIES OR FLASHBACKS • RUNNING AWAY • PROSTITUTION • REASSURE ONESELF THAT THEY ARE ALIVE AND IN REALITY • AGGRESSION • SUICIDE • INCREASE ONES SENSE OF AUTONOMY

• DELINQUENCY • PROMISCUITY

10 SURVIVORS WHO SELF MUTILATE SELF MUTILATING BEHAVIOR SHOULD DESCRIBE…. ALWAYS BE ASSESSED CAREFULLY

• A PERIOD OF ESCALTING GUILT, SELF- • THE FUNCTION AND MEANING TO THE SURVIVOR AND INCREASING DISGUST WITH IS IMPORTANT BEFORE DIAGNOSTIC OR SELF JUST PRIOR TO SELF INJURY LEADING PROGNOSTIC ASSUMPTIONS ARE MADE BECAUSE SOME INTENSELY SUICIDAL INDIVIDUALS ALSO TO AN OVERWHELMING DESIRE FOR SELF-MUTILATE PUNISHMENT • AFTER SELF INJURY THESE NEGATIVE COGNITIONS USUALLY ABATE AND A PERIOD OF CALM AND RELIEF ENSUE

WITHDRAWAL OTHER EFFECTS OF SEVERE ABUSE • SYMPTOMS ASSOCIATED WITH PRIOR SEX • ABILITY TO AVOID, • COMPLAINTS OF ABUSE INVOLVE THE SURVIVOR’S DENY AND REPRESS ISOLATION AND EXPERIENCE OF ESTRANGEMENT, • HYPERSENSITIVITY NEEDINESS IN THE ABSENCE OF SELF- ISOLATION AND ALIENATION FROM OTHERS AND EXTREME EMOTIONAL SUPPORT REACTIVITY TO • BOUNDARY PROBLEMS • THESE RESULT IN A TENDENCY TO OTHERS • CHRONIC PERCEPTION WITHDRAW FROM THE SOCIAL MILIEU OR • GULLIBILITY AND OF DANGER TO BE REJECTED BY IT • SELF HATRED

TRANSFERENCE IS A LOGICAL EXTENSION OF TRANSFERENCE ISSUES THE CLIENT’S CHILDHOOD EXPERIENCE

• RAGE • IT PROVIDES VALUABLE INFORMATION • SEXUALIZATION-FLIRTATION, SEXUAL SUGGESTIONS OR INVITATIONS, DRESSING • IT PROVIDES THE OPPORTUNITY TO REDO OR ACTING IN A MANNER INTENDED TO BE OR RECONSIDER IMPORTANT CHILDHOOD SEXUALLY INTERESTING OR AROUSING ISSUES AND EXPERIENCES • SEXUALIZATION DOES NOT MEAN SEXUAL INTEREST • IT IS IMPORTANT FOR THE THERAPIST NOT TO PERSONALIZE THE TRANSFERENCE

11 HOW TO RESPOND TO TRANSFERENCE COUNTERTRANSFERENCE

• NONPARTICIPATION- DON’T RESPOND • THIS IS THE THERAPIST’S BIAS TO OR REACT TO THE HOOKS BEHAVIORS THAT ARE BASED ON • BOUNDARY CLARIFICATION- BE EARLIER LIFE EXPERIENCES OR CLEAR ON THE NON-NEGOTIABLE LEARNING LIMITS OF THERAPY • TWO MAJOR SOURCES • REFRAMING-ANALYZE INTERACTION – THERAPIST’S OWN CHILDHOOD ABUSE AND DEFINE ITS PURPOSE; FOCUS ON – ISSUES RELATED TO THERAPIST GENDER FEELING THAT UNDERLY THE BEHAVIOR

THE JOB OF THE THERAPIST IS NOT TO THERAPY TECHNIQUES PUNISH THE ABUSER BY PROXY BUT, TO PROVIDE AN ENVIRONMENT • NORMALIZATION • INFORMATION/EDUCATION WHERE THE SURVIVOR CAN • CONTACT WITH OTHER SURVIVORS INTEGRATE HIS/HER EXPERIENCES • CLARIFICATION AND RECOVER TO THE BEST OF • FACILITATE EMOTIONAL DISCHARGE COMMON FEARS: – BEING OVERWHELMED OR SWALLOWED UP BY INTENSE THEIR ABILITY AFFECT – LOSING CONTROL AND ACTING ON SADNESS OR RAGE – OF SOMEHOW MAGICALLY RETURNING TO THE ABUSE BY VIRTUE OF FEELING ABUSE CONNECTED PAIN

RECOVERY MOST IMPORTANTLY ONGOING PHASE

• A THERAPIST WHO IS CARING, • DECISIONS ON FAMILY AND OTHER LIFE NONEXPLOITIVE AND RELIABLE DECISIONS • A THERAPEUTIC ENVIRONMENT THAT • DEVELOPMENT OF NEW COPING SKILLS FOSTERS SELF-AWARENESS, SELF- • NEW OUTLOOK ON THE WORLD ACCEPTANCE AND INDIVIDUATION/ INDEPENDENCE • ID FUTURE TRIGGERS, CLIENT AND • THE CORRECTIVE INTERPERSONAL SUPPORT SYSTEM EXPERIENCE OF ABUSE FOCUSED • TEMPORARY BREAK FROM THERAPY PSYCHOTHERAPY IS AS MUCH ABOUT HOW THE THERAPIST IS AS IT IS WHAT SHE/HE SAYS

12 PREVENTION VIDEO PREVENTION 2 MINUTES

• EDUCATION OF CHILDREN AND ADOLESCENTS • EDUCATION OF ADULTS • EDUCATION PROGRAMS IN OUR COMMUNITIES ARE YOUR RESPONSIBILITY • EDUCATION PREVENTS ABUSE

ROSIE VIDEO WHO TO CALL…..

• LOCAL POLICE OR SHERIFF • CPS: 1-800 252-5400 • CHILD ADVOCACY CENTERS • NATIONAL CHILD ABUSE HOTLINE: 1-800 422-4453

QUESTIONS……

13