How Trauma is Experienced and Its Impact on Your Clients
Understanding how trauma manifests and is experienced by your clients is crucial. This article will explore the complexities of trauma, particularly how childhood abuse can shape adult perceptions, behaviours, and identities.
Drawing on insights from Christiane Sanderson’s work on child sexual abuse (CSA) survivors, we will explore the profound effects that trauma can have on adult survivors and discuss practical approaches for therapists in addressing these issues.
Learning Outcomes
By the end of this article, you will:
- Understand the long-term impacts of childhood trauma on adult behaviour and identity, particularly concerning sexuality and personal relationships.
- Recognise the potential triggers that may bring clients into therapy years after the traumatic event.
- Develop strategies to meet clients where they are, navigating their perceptions and behaviours without imposing judgments.
- Reflect on their role in the therapeutic relationship, considering how their presence and interventions may influence clients dealing with past trauma.
The Impact of Childhood Trauma on Adult Identity and Behaviour
Child Sexual Abuse (CSA) Definition
Child Sexual Abuse (CSA) is defined as a deeply traumatic experience where a child is prematurely exposed to sexual stimulation, which can have profound and long-lasting psychological impacts. Premature sexual activity is often associated with negative emotions and memories, making sex and sexuality central organising principles of the survivor’s personality and identity.
This experience can lead to a range of complex psychological outcomes, such as confusion around sexual identity, fear of physical contact, and distorted perceptions of sexuality, love, and aggression.
Childhood trauma, particularly CSA, often leaves deep-seated psychological scars that manifest in various ways during adulthood. These manifestations can be complex and multifaceted, affecting how survivors perceive themselves, their relationships, and their sexuality.
Sexuality and Identity Confusion
One of the most pervasive impacts of CSA is confusion around sexuality and identity. As Sanderson points out, survivors may see themselves primarily as sexual objects, leading to a distorted sexual script. This script can result in preoccupations and obsessions that are both arousing and confusing. Such confusion can extend to their sexual identity, where survivors might mistakenly attribute the sexual responses they experienced during abuse to their sexual orientation. For instance, a male survivor might question whether his sexual arousal during the abuse indicates a homosexual orientation, which can be deeply confusing and distressing.
Fear of Physical Contact
Physical contact is another area greatly affected by trauma. Survivors of CSA often experience a dichotomy of craving and repulsion towards touch. This ambivalence can complicate their relationships, where they might both seek and avoid physical intimacy. Understanding this dynamic is crucial for practitioners, particularly in setting boundaries within the therapeutic relationship to avoid triggering distressing memories or reactions.
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Fetishism and Tactile Hunger
Sanderson describes “tactile hunger” as a condition where the lack of appropriate physical contact during childhood can lead survivors to seek comfort in fetishes or specific textures, like fur or silk. This behaviour is a coping mechanism, allowing survivors to experience safe, pleasurable sensations. Understanding the origins of such behaviours can help counsellors and psychotherapists address clients with empathy and without judgement.
The Conflation of Sex, Love, and Aggression
Another complex outcome of CSA is the conflation of sex with love and aggression. Survivors might struggle to differentiate between affection and sexual arousal, or they might equate sexual activity with aggression. In some cases, this can lead to sadomasochistic behaviours or a desire to victimize others. Although these outcomes are less common, they highlight the need for therapists to carefully navigate discussions around sexual behaviour and aggression with their clients.
The Dormant Nature of Trauma and Its Triggers
Trauma does not always manifest immediately; it can remain dormant for years, only resurfacing when triggered by specific life events or developmental milestones. Therapists must be attuned to these potential triggers, which can range from entering a first adult relationship to witnessing a child reach the age at which the client was abused. Other triggers might include media reports, the death of an abuser, or even medical examinations.
Understanding these triggers allows you to better support clients who may suddenly seek help after years of silence. Recognising that trauma can be “buried” for decades also challenges the misconception that delayed responses to abuse are somehow less legitimate or fabricated.
Meeting Clients Where They Are
A critical aspect of trauma-informed therapy is the concept of “meeting clients where they are.” This involves being patient and non-judgmental and allowing clients to explore their experiences at their own pace. For example, when a client expresses confusion about their sexual identity due to past abuse, the therapist’s role is to facilitate a safe exploration of these feelings rather than impose a definitive interpretation.
Counsellors must also be mindful of their role within the therapeutic relationship, particularly concerning transference. Clients might project onto their therapists’ roles, such as protectors or parents, which can be both a challenge and an opportunity in therapy. Reflecting on “Who am I to the client?” can help you navigate these dynamics effectively.
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Final Remarks
In conclusion, trauma, especially CSA, can have long-lasting and complex effects on survivors, influencing their perceptions of self, sexuality, and relationships. Counsellors and psychotherapists must be equipped with the knowledge and skills to recognise these effects and work sensitively with clients who are navigating the aftermath of such trauma. By understanding the nuances of trauma and being attuned to each client’s unique needs, you can provide the support necessary for healing and growth within your practice.
References and Further Reading
Sanderson, C. (1990). Counselling Adult Survivors of Child Sexual Abuse. London: Jessica Kingsley Publishers.
Van der Kolk, B. (2015). The Body Keeps the Score. UK: Penguin Books.