ISSTD Chapter Meeting Presentation Heather Pierce, MSEd, LCPC December 6, 2019 Separation from Abusing Families: Systems, Safety, Stigma, and Support Systems — A range of circumstances likely for people with DID/Big T trauma • Emotionally, physically, and sexually abusive caretakers o Maintaining control and abusive patterns through dependency and enmeshment of all kinds (emotional, physical, financial, familial), trauma bonding, and shame o May also involve real or perceived threats of harm • Ritual abuse and mind control o All of the above, and: § More likely to also involve real or perceived threats of harm, violence, abduction, or death § Incredibly complex and dangerous systems involving multiple perpetrators • Themes of Attachment vs. Entrapment – from childhood to adulthood o “The victims of such abuse typically feel ‘fused’ with their abuser and do not feel that their body belongs to them. They generally have intense but ambivalent attachments to the perpetrator. Such abusers typically involve their victims in one or other forms of organised abuse.” (Middleton, 2019) o Trauma bonding: The attachment bond that is created through repeated abusive or traumatic childhood experiences with the caregiver, whereby this relationship pattern becomes internalized as a learned pattern of behavior for attachment. (Carnes, 1997) o “…the nature of shame and its capacity to erode selfhood to the point that any form of assertive action gives way to dutiful compliance.” (Middleton, 2017) o “Child abuse in the form of emotional, psychological, sexual, or physical abuse was cited by 13.9% of children who initiated estrangement with one or both parents as a reason for estrangement. Furthermore, 2.9% of estranged parents acknowledged their failure to prevent the abuse.” (Carr, Holman, Abetz, Kellas, & Vagnoni, 2015) Safety and Separation — Unique and different strategies • Separation is most often a process, not an event • Navigating safety is crucial o Systems are complex and solutions are individual o The client is the expert about their system and is most likely is the best guide for knowing and managing threats to safety o Domestic Violence protocols can be a good general model for safety planning • Risks — Immediate and ongoing o Remember that people are in the greatest danger when they are preparing to leave or are actually leaving the abusive system 1 § The perpetrator(s) will likely be triggered by the highly charged impacts of shame and threats of/actual exposure o The process of “getting out” can take months, but it is only a small piece of the long journey of separation o After separation, sustaining safety also requires support and vigilance § The survivor may suffer a range of impacts that can be emotional, physical, financial, professional, or environmental § Emotional and physical threats to self will often be ongoing o Expect a lingering pull to return to the abusive system Stigma • Going against widespread cultural narratives o “Family First” o “Blood is thicker than water” o “Never forget who was with you from the start” o “We may not have it all together, but together we have it all” o Narratives of loyalty, obligation, and duty o Parent-child power differentials and “father knows best” o Can be even stronger in more collectivist cultures than the U.S. • Being “outed” in a different way o Family of Origin/extended family is the culturally normative definition of “family” § Survivors are especially vulnerable to expectations and exposure around certain holidays and life events o The survivor likely will have an alternative configuration of “family” that may indicate to others the existence of abuse/dysfunction and invite questions or judgment § Exposure, isolation, and “otherness” § May trigger a return of the abusive system dynamic of secrets, silence, and shame Support – the emotional and therapeutic frame “Satisfaction, well-being, and happiness will not result from estrangement alone. Rather it involves a courageous, honest assessment of self within the family context—and a lot of hard work outside of it.” (Agllias, 2015) • The powerful pull of attachment o Remember that attachment is connected to survival and resiliency § There is a justifiable longing and reasons to resume attachment to abusers • Distancing and isolation are counterintuitive to caretaker-child/survival instincts • Trauma bonding is an especially powerful form of attachment o Role reversals in caregiving, as abusers, bystanders, and other victims in the system are wounded people, too § Equating the sins of abuser with the sin of betraying the family/system • The survivor becomes the “bad object” • Can be intensified by the reactions of the abusive system to the separation and exposure § Separation requires knowing and action; dissociation has to be diminished or abandoned as a way to “not know” in order to maintain attachment to the abuser 2 “Disentangling [the survivor’s relationship with their abusive system] from the harm which is done through the relationship is as painful as the harm itself.” (Middleton, 2017) • Emotional Impact of Separation from Family o After finding some sense of safety and acceptance, family/system separation is likely to activate a grief response (among other responses): § Disenfranchised grief (Doka, 1989) • Disenfranchised grief occurs when an individual’s grief experience is not recognized or acknowledged by others § Stigmatized grief (Bloom, 2000) • Others fearing contagion, blaming the victim, or victims believing they should have done something to prevent the abuse, or that they deserve what happened to them § Ambiguous loss (Boss, 2006) • The survivor may not achieve the final grief stage of acceptance, given that the loss of the relationship is potentially reversible • In the therapy room o A non-linear nature to the work § People may go in and out of attachment and danger; they will likely vacillate between activation and acceptance • And so goes their emotional states and regulation § Until people are free from abusive systems, there will be a limit to what can be healed and empowered in therapy o Attention to their safety and ours; legal, ethical, and risk management considerations § Struggles to distinguish between what is likely and what is feared • Within ourselves as therapists o The grief, pain, and powerlessness of knowing that our clients are in and/or returning to abusive systems o The glacial pace, limitations, or regression of therapy § Therapist frustration and self-doubt § Coping with seeing our clients hurt in the context of being helped § Repeated cycles of steps forward and backward, trying to repair the damage done by abusers o Peace and hope in knowing that without therapy, there is little to no chance survivors will be free from abusing systems § Validation may never appear in any meaningful form unless it is through professional (our!) help References Agllias, K. (2011). Every family: Intergenerational estrangement between older parents and their adult- children (doctoral dissertation). University of Newcastle, Callaghan. Agllias, K. (2011). Utilizing participants’ strengths to reduce risk of harm in a study of family estrangement. Qualitative Health Research, 21, 1136-1146. 3 Agllias, K. (2013). Family Estrangement. Encyclopedia of Social Work. Subject: Couples and Families, Aging and Older Adults, Children and Adolescents. Agllias, K. (2015, March 2). What we lose [blog post]. Retrieved from https://www.psychologytoday.com/us/blog/family-conflict/201503/what-we-lose-and-gain-when- family-separates Agllias, K. (2015). Difference, choice, and punishment: Parental beliefs and understandings about adult child estrangement. Australian Social Work, 68(1), 115-129. Agllias, K. (2016). Disconnection and decision-making: Adult children explain their reasons for estranging from Parents. Australian Social Work, 69(1), 92-104. Agllias, K. (2017). 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