Rethinking Trauma Treatment by Courtney Armstrong

Author:Courtney Armstrong [Courtney Armstrong]
Language: eng
Format: epub
Tags: Epub3
Published: 2019-03-08T00:00:00+00:00

10

Childhood Physical Abuse

Forming a secure therapeutic alliance with clients who’ve suffered childhood abuse and neglect can be challenging. If the abuse was severe, repetitive, and began at a young age, it is likely the client developed a disorganized attachment style. With disorganized or unresolved attachment, the client has intense conflicts about getting close to people. As children, the very people with whom they needed to attach for survival were also the people who posed the greatest threat to their existence. They long for loving, caring relationships, but expect to be betrayed, abandoned, or hurt by people.

As a result, people with disorganized attachment have a blend of both avoidant and anxious attachment traits. They can be preoccupied with having close relationships one moment, then suddenly distance or cut off from a relationship the next. They can feel fragmented as they vacillate between different “parts” of themselves. Not all people with disorganized attachment styles develop dissociative identity disorder. But they can quickly regress to traumatized states when stressed and appear to have different personas.

When these clients come to therapy, they are usually in crisis—either struggling with suicidal ideation, a destructive relationship, or chronic health problems. Before you can reconsolidate their traumatic memories, you have to stabilize the crisis, and patiently work to build trust and rapport. Once the crisis is sufficiently stabilized, it is helpful to reconsolidate traumatic memories so clients can begin to build new perceptions of themselves, the world and others. These clients can struggle with inner conflicts through the memory reconsolidation process, as they attempt to reconcile their longing for love with their fierce instincts to protect themselves. Through a case example with my client Pamela, you’ll see why it can feel like you’re moving one step forward, then two steps back, when working with these clients. Yet the effort to patiently walk through the difficult journey with these clients is worthwhile, as they have the greatest need and capacity to heal.

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