From a therapist’s perspective… (guest post)

When I began specialist therapy I was unable to speak the words I desperately wanted and needed to, in order to recover. I had learnt how to be silent about the abuse; as a child, as a teenager and well into adulthood, only disclosing after attempting to take my own life at the age of thirty. I made a few attempts at trying to ‘get better’ but nothing seemed to work. Medications numbed me but did nothing to change the way I felt about the trauma. CBT missed the point entirely and psychotherapy was too cold and detached. EMDR, that provides relief for many, felt too intense, pushing me out of my comfort zone and triggering me to the point of being unsafe.

We are all different, and what works for one survivor may not help the next. In my case, I needed complete trust in the therapist. To take things at my own pace. I needed someone who wasn’t afraid to show empathy, or to hold my hand if that is what I required at the time. I needed someone intuitive to help me unlock the ‘Big Black Door’ in my mind, behind which I kept my trauma, to support me to find my voice and tell my story. I was fortunate to find the right person and, in time, recovery for me was to be found at the end of a pen. Only through writing was I able to finally tell my story. This month’s guest post is from the perspective of a person-centred therapist. She has worked for many years with survivors of sexual violence.


From a therapist’s perspective, one of the first difficulties encountered with the treatment of Child Sexual Abuse (CSA) lies with the medical diagnosis. It is not given it true name which is Trauma due to severe abuse. Instead it is labelled as Depression; Anxiety; Post Traumatic Stress Disorder (PTSD); Psychosis; Self-harming; BPD; DID; OCD etc.

 As the names become more exotic, abbreviations begin to emerge which allow the labels to trip off the client’s tongue more easily and so, it becomes their litany. As they label themselves, so they become rife for medication with all its side effects requiring even further pills and potions. Of course, this is not to deny that sometimes medication may be required, particularly if the trauma has been undiagnosed for years which is often the case. However, if these symptoms are the diagnosis what then might the root cause of these behaviours be? Once the root cause is eventually discovered this would raise the question – What normal human being would not be trembling with fear and displaying any one of these symptoms, if not all, when they have been repeatedly raped and abused – emotionally, physically and psychologically. These symptoms which become a diagnosis of mental abnormalities are in fact perfectly normal reactions to a completely abnormal and insane act upon a child. 

Silence compounds the trauma even further. All too often a child will not reveal what has happened to them until they are well into their thirties; forties and even older. The age is gradually coming down to twenties so that at least an adult is not destined to spend most of their life never revealing what the real cause of their inadequacies coping with the world around them, is really all about. This is as a result of specialised centres for sexual abuse but these are limited. Breaking the silence requires patience, a variety of tools and many months if not years of support. In my time as a therapist I have used sketch pads with pencils, crayons and paints; journaling; writing stories in the form of a fairy tale; music; dance; poetry; letter writing; sand tray therapy and even a Sindy Doll House.

When working with childhood trauma it requires creativity. As the silence begins to break, an increase in flashbacks, panic attacks and body memories are common, as the floodgates to the unconscious mind are opened. The client may have been experiencing these for some time already as the trauma box they are holding inside of themselves, overflows. This may also involve nightmares so that sleep can be limited to 2 or 3 hours per night if they are lucky. Flashbacks and dreams, however, if they can be managed can become the most valuable key to the past, as the memories are released bit by bit and the story can be told. Writing or drawing out the story is just the beginning. Next it needs a voice and as the storyteller says the words aloud, validation begins, emotions are released and tears begin to flow. The abused person can finally move from a feeling of numbness, even if that feeling at first is one of intense pain. When questioned about the pain, most clients feel it in their chest and not surprisingly, around the heart. They then go on to describe a deep sense of loss, of something being taken from them – a piece missing. Finally they will make their own diagnosis – ‘I feel as though my soul has been taken.’ My own personal analogy of this is that of a set of Russian dolls. The inner most one, the smallest, is solid. I liken this to the soul. Around this fits all the other dolls as they increase in size and can be likened to the child growing through the years into adulthood. At any stage too, some of these may become fractured due to additional trauma and create a hollow feeling. However, without the tiny doll in the centre, all the other pieces will never feel whole and will always feel unstable. Without the soul, the person is never complete. Thousands of years ago, the ancient practitioners known as Shamans, realised that soul retrieval was a necessary part of treatment for trauma. In the modern world ‘soul’ let alone its retrieval would be seen as hocus-pocus and hence the tendency to medicate. Yet almost all the clients I have worked with throughout the years, describe the same phenomenon. Mindfulness and meditation have been slowly introduced by the mental health services as a form of acceptable therapy, but often the mind of a deeply traumatised person is too full of trauma and they have no sense of inner self because it has been taken from them. It is not easy to practice such techniques in the early stages of trauma recovery.

As a trauma therapist, I see my job as one of reuniting the frightened, abused child with their adult self and teach them how to love again, most of all themselves. Love is the key therapy in child sexual abuse and my usual method of working is for the client to take a pencil and paper and begin to draw with the non-dominant hand. Often a picture similar to that drawn by a child when they first have a sense of self, emerges – a large head, two little stick arms and legs and a triangle for a dress. Then a dialogue begins with the adult asking the child in the picture, how they are. The child often replies back that they are frightened and want to be put somewhere safe. As the dialogue continues the adult then begins to realize that they were just a little child and therefore blame, shame and guilt belong not to the little child but to the adult abuser. As this system of false belief systems they have carried over the years, begins to fall away, the recovering survivor can begin to see that they were an innocent, sweet child who had done nothing wrong. Their only fault lay with the fact that they were born into a house where a predator lived and they could not tell anyone that they lived with a monster in their family.

Patricia Walsh

Author of Cancer – A Magical Quest

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