ST. MARY S UNIVERSITY

Transcription

1 ST. MARY S UNIVERSITY SUNKYUNG CHUNG M.A., LPC-INTERN MONIQUE MERCADO M.A., LPC-INTERN ALLISON ATKINSON M.A., LPC-INTERN RAY WOOTEN PH.D., LPC-S, RSMT

2 LEARNING OBJECTIVE We hope you will: 1. Gain knowledge of the impact of childhood sexual abuse on the lives of adolescent children 2. Gain knowledge in a body-oriented approach to working with adolescents using somatic mindfulness and body-awareness 3. Gain knowledge and skills in breathing techniques used in working with adolescent children

3 SEXUAL ABUSE SURVIVOR VIDEO

4 CHILD SEXUAL ABUSE Any interaction between a child and an adult (or another child) In which the child is used for the sexual stimulation of the perpetrator or an observer Touching & Non-touching The language What is it? What does it look like? All ages, races, ethnicities, & economic backgrounds

5 CHARACTERISTICS OF THE ABUSER Use of play, deception, threats, or other forms of coercion Persuasive & manipulative tactics Grooming 90% Of children who are victims of sexual abuse KNOW THEIR ABUSER 60% Of children who are sexually abused are abused by people the FAMILY TRUSTS 30% Of children who are sexually abused are abused by FAMILY MEMBERS

6 STATISTICS 1 in 10 Children will be sexually abused before their 18 th birthday 1 in 5 girls and 1 in 20 boys are a victim of child sexual abuse

7 SURVIVORS ARE 3 times more likely to suffer from depression. 6 times more likely to suffer from post-traumatic stress disorder. 13 times more likely to abuse alcohol. 26 times more likely to abuse drugs. 4 times more likely to contemplate suicide World Health Organization

8 CHALLENGES INTO ADULTHOOD Psychological Physical Sexual Abuse Emotional Social

9 TRAUMA An event outside of normal human experience that leaves you feeling powerless, helpless, and paralyzed Sudden & overwhelming Assault to a person s biology and psyche

10 POST TRAUMATIC STRESS DISORDER Severe feelings of anxiety, stress, or fear Three main categories: Re-Experiencing Avoidance Hyper-arousal National Institute of Mental Health

11 PTSD: RE-EXPERIENCING Repeated reliving of the event Interferes with daily activity. Hours Flashbacks, frightening thoughts, recurrent memories or dreams, & physical reactions to situations that remind you of the event. Weeks Days

12 PTSD: AVOIDANCE Symptoms stem from the desire of a person to change their routine to escape similar situations to the trauma Avoid places, events, or objects that remind them of the experience Numbness, guilt, and depression Unable to remember major parts of the trauma

13 PTSD: HYPER-AROUSAL Symptoms are all physiological Difficulty concentrating or falling asleep Being easily startled Feeling tense, on edge Angry outbursts

14 PHYSICAL SYMPTOMS Visible, yet invisible Not as common as emotional & Behavioral (Social) signs Can the body tell the story? Do we allow it?

15 PHYSICAL SYMPTOMS CONT. Body memories (psychosomatic symptoms) Headaches/migraines Chronic Pain When the stress of the memories of the abuse experienced by an individual take the form of physical problems that cannot be explained by the usual means (medical examinations, etc.). Stomach difficulties Light headedness/dizziness Hot/cold flashes Grinding of teeth Sleep disorders, etc.

16 CASE EXAMPLE Jenny,16-years-old, is sent to Rape Crisis Center by her aunt. Jenny s aunt reported that Jenny recently disclosed that she was sexually abused by her older cousins when she was 5 to 12 years-old. Jenny has felt anger, depression, and anxiety. Jenny has learning difficulties, poor concentration, and low attention. Jenny committed suicide and has been drinking.

17 I DON T WANT TO TALK ABOUT IT Often refuse to attend therapy sessions Often refuse to speak when they do attend therapy Negative perception of counseling Trust

18 S E C R E T

19 ANGER

20 GOALS FOR THERAPY

21 TREATMENT MODALITIES Traumafocused Integrative- Eclectic Therapy (IET) Traumafocused Play Therapy Traumafocused Cognitive- Behavioral Therapy (CBT) Sand Tray Eye Movement Desensitiza tion and Reprocessi ng (EMDR) Individual Child and Parent Physical Abusefocused Cognitive- Behavioral Treatment Cognitivebehavioral and Dynamic Play Therapy for Children with Sexual Behavior Problems and Their Caregivers Cognitive Processing Therapy (CPT) Treatm ent for Adolesc ents with CSA Therapeu tic Child Develop ment Program Resilient Peer Training Interventi on

22 PSYCHOSOMATIC ISSUES Eating disturbance Possible immune system dysfunction Headache Sleep disturbance Stomachache Pregnancy Increased catecholamine level Dysregulated cortisol Problems walking Problems sitting Genital odors and itching Genital pain STDs

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24 MINDFULNESS STARTS WITH THE BODY Somatic mindfulness involves an intentional focus on and awareness of internal body sensation

25 HEALING TASKS FOR SURVIVORS OF ABUSE The Healing Tasks Model for survivors of abusive trauma is based on the principles and concepts derived from Gestalt therapy Jim Kepner (1995). Healing Tasks: Psychotherapy with Adult Survivors of Childhood Abuse Healing as Cure Versus Healing as Growth The medical model in the western culture Healing as Growth

26 HEALING TASKS AND PHASES OF HEALING

27 DEVELOPING SUPPORT Phenomenology of the Abusive Context Aspects of the traumatic experience Interdependence Establishing the Therapeutic Environment as Support Trust Safety, Containment Boundaries, and the Treatment Frame Developing support has to do with creating the interpersonal and systemic field that supplies the necessary conditions for other tasks of healing to take place, as it restores the link to other people that is often severed by abuse (Kepner, 1995).

28 DEVELOPING SELF FUNCTIONS Boundary Functions Experiencing Functions Self-Support Functions Feeling Functions Reality-Perception Functions

29 UNDOING, REDOING, AND MOURNING Undoing Retroflected Core Retroflections Self-enactments of abuse Introjections Undoing, Redoing, and Core Memories Mourning

30 RECONSOLIDATION Transcendence and Reconsolidation The Reconsolidation Task by Phase of Healing Support phase Self-Functions Phase Reconsolidation in the other phases Mourning in the reconsolidation phase The Question of Forgiveness

31 MEMORIES AND REMEMBERING The Question of Trauma and Memory Traumatic Memory and Forgetting Approaches to Traumatic Memory Importance of Remembering and of Not Remembering Trauma Forgotten and Recalled The field now offers support or capacities that the person did not have before Developmental demands may evoke otherwise well-shut-off memories because certain capacities are called on that are linked to those memories Stresses in the field, or other life events, cause memories to be more easily triggered and recalled.

32 CYCLE OF REMEMBERING A natural consequence of the emergence of an experience that was originally fragmented from consciousness. Memory fragment Shock The recollection of any new traumatic memory results in at least some experience of shock. Shock is experienced due to the charge of affect the memories carry. Doubt is a natural process which where the experience is gradually assimilated and the Gestalt of who we are and what we are about is reorganized. Doubt shifts into self-doubt. Self-doubt Affirmation The survivor can begin to affirm that what has emerged has at least some kind of truth in it. Support and self functions are brought to bear on the process of reorganizing the gestalt. Inclusion Restructuring and consolidation The impact of remembering

33 THE SOMATIC PROCESS IN HEALING Why is the body important in the Process of healing? The Survivor and the Bodily Self Not being a whole person Inability to self-regulate Somatic symptoms and shame Therapy and the Bodily Self

34 CONTRIBUTIONS OF SOMATIC PROCESS Support Orienting and reality Grounding Self-care and Nurturance of the Body Self functions Reclaiming the Bodily Self Rebuilding the Bodily Self Undoing, redoing, and mourning Reconsolidation

35 ASSESSING THE HEALING PROCESS So how do we know which phase the client is in? Using the checklist A way to organize critical thinking Marking and Evaluating the Checklist

36 SOMATIC MINDFULNESS IN CONTEXT Experiential with Dr. Ray Wooten Registered Somatic Movement Therapist

37 REFERENCES Kepner, J. (1995). Healing Tasks: Kerr, C. E., Sacchet, M. D., Lazar, S. W., Moore, C. I., & Jones, S. R. (2013). Mindfulness starts with the body: Somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation. Frontiers In Human Neuroscience, 7 (12). Kimbrough, E., Magyari, T., Langenberg, P., Chesney, M., & Berman, B. (2010). Mindfulness intervention for child abuse survivors. Journal Of Clinical Psychology, 66(1), Langmuir, J. I., Kirsh, S. G., & Classen, C. C. (2012). A pilot study of body-oriented group psychotherapy: Adapting sensorimotor psychotherapy for the group treatment of trauma. Psychological Trauma: Theory, Research, Practice, A nd Policy, 4(2), Lilly, M. (2010). Healing Childhood Sexual Abuse with Yoga. International Journal Of Yoga Therapy, 20,