body experiences of women survivors of child sexual abuse

253 Pages·2000·14.11 MB·English

BODY EXPERIENCES OF WOMEN SURVIVORS OF CHILD SEXUAL ABUSE:
IMPLICATIONS FOR THERAPEUTIC INTERVENTION
Margit E. Asselstine
A niesis submitted in confonnity with the requirements for the
Degree of Doctor of Education. Graduate Department of Adult Education,
Cornmunity Development, and Counselling Psychology
University of Toronto
Copyright by Margit E. Asselstine, 1997
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Body Experiences of Women Survivors of CMd Sexual Abuse:
Implications for Therapeutic Intervention
by Margit Asselstine
A thesis submitted in conformity with the requirements for the degree of Doctor of
Education, Graduate Department of Adult Education, Cornmunity Development, and
Counselling Psychology, University of Toronto, 1997.
ABSTRACT
Previous research identifies the impact of child sexual abuse on a child's cognitive and
emotional orientation to the world but has neglected to include its impact on the child's
physical orientation to the wodd. Conventional psychotherapeutic practice has few if any
techniques for including the physical dimension within verbal exploration and integration.
Research, however, continues to show the necessity for a non-intellectual approach for
accessing state-bound information for the purpose of traumatic mernory retrieval and
integration. The intention of this study was to explore the body experiences of women
survivors within a verbal body-focused intervention that did not involve touch or movement
therapy. This study demonstrates that the body is closely and inexûicably involved when
trauma is experienced, particularly in childhood sema1 abuse.
Five women survivors of child sexual abuse, al1 of whom were currently in
psychotherapy, participated in one body-focused verbal experiential session. The session was
followed by two interviews one week and one year Iater to discuss and evaluate their body-
oriented experience and its relationship to their healing process. An interna1 focus on their
body experience created a non-ordinary state in which the body could speak from its own
perspective without the filter of the intellect. Following the sensation of a memory led the
participants either to a memory of the abuse itself or to an unresolved related issue. The
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results ïndicate that a variety of kinaesthetic experiences are part of the memory of trauma.
including the trauma of immobilization and the feeling of being physically trapped in terror,
body disruptions that involve the rnind "splittïng" from the body, and the "splitting" of body
areas that represent separated parts of self with diffe~gpe rspectives on the trauma.
Following the sensation of a memory and incorporating psyche-soma linking led the
participants to a changed and more integrated relationship with their body. Body-oriented
memory retrieval and integration, and the intemalization of the process of dialogue with their
body 1ed these women to new opportunities for healing that would not have been available
otherwise.
TABLE OF CONTENTS
Abs tract
List of Figures
List of Appendices
Acknowledgements
1. INTRODUCTION
1.1 . Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2. Locating Myself as a Researcher . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 2
1.2.1. My Personal Evolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2.2. Evolving a Research Topic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.2.3. Rationale for the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 . LITERATURE REVIEW
2.1. Theories Relating Psyche and Soma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.2. The Effects of Child Sexual Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
2.3. Trauma and Memory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
2.3.1. How Children Remernber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
2.3 .2. Myths and Misconceptions about Reality Versus Fantasy . . . . . . . . . . . 26
2.3. 3. Accessibility of Traumatic Memories . . . . . . . . . . . . . . . . . . . . . . . 27
2.3. 4 . Trauma and the Body Experience . . . . . . . . . . . . . . . . . . . . . . . . . 30
2.3.5. The Relevance of State Dependency . . . . . . . . . . . . . . . . . . . . . . . 34
2.3.6. Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
V
3 . RESEARCH OBJECTIVES AND METHOD
3.1. Research Objectives and Research Questions . . . . . . . . . . . . . . . . . . . . . . . 47
3.2. The Development of a Body-Focused Psychotherapeutic Intervention Technique . 48
3.2.2. Finding a Conceptual Framework . . . . . . . . . . . . . . . . . . . . . . . . . 49
3 .2.3. Finding a Body Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
3.2.4. Acknowledging the Therapy Relationship . . . . . . . . . . . . . . . . . . . . 52
3 .2.5. Understanding the Experiential Session . . . . . . . . . . . . . . . . . . . . . . 55
3.2.6. Continuous Body-Refocusing Facilitates Psyche-Soma Linking . . . . . . . 59
3.2 .7 . Approaches to the Inclusion of the Body in Related Therapy . . . . . . . . . 60
4 . METHODOLOGY
4.1. Adopting a Heuristic Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
4.2. Women's Personal Experience of Their Body: A Case Study . . . . . . . . . . . . . 65
4.3. TheShxdy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
4.3.1. Women Survivors of Child Sexual Abuse: The Research Participants . . . 68
4.3. 2. The Role of the ResearchedFacilitator: Engaging in the . . . . . . . . . . . 69
Therapeutic Process
4.3.3. Four Data Collection Phases . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
4.3.4. Qualitative Data Analysis : Creating St ories . . . . . . . . . . . . . . . . . . . 75
4.3.5. Beuig Informed by the Pilot Smdy . . . . . . . . . . . . . . . . . . . . . . . . 76
CASE STUDIES OF FIVE WOMEN'S EXPERIENTIAL SESSIONS:
FESEARCH FINDINGS
Organization of the Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Mary's Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Gwen's Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Willo 's Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Trudi's Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 22
Laura's Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
THOUGHTS. REFLECTIONS AND INSIGHTS RELATED TO
THE EXPERIENTIAL SESSIONS: RESEARCH FINDINGS
The Healhg Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
6.1.1. Individual Modalities for Entry to the Body Expenence . . . . . . . . . . . 150
6.1.2. The Head-Body Split and Betrayal by the Body . . . . . . . . . . . . . . . . 153
6.1.3. Body Parts in Dialogue. Psyche-Soma Linking. Iritegrating . . . . . . . . . 159
the Hurt Child. and Creating Healing hagery
6.1.4. New Self-Care Strategies and Tools . . . . . . . . . . . . . . . . . . . . . . . 171
Participants' Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
6.2.1. A Process Not Dorninated by the Intellect Facilitates Integration . . . . . . 185
6.2.2. The Session Facilitates Memory Recall and Retrieval of Images . . . . . . . 187
that Would Not Have Happened Otherwise
6.2.3. A Flexible Physical Environment Provides Opportunities to . . . . . . . . . 190
Explore Body Processes
6.2.4. A Therapeutic Relationship of Trust. Safety. and Gentleness and the . . . . 191
htemalization of the Therapist's Trust in the Process 1s Helpful
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6.2.5. A Self-Directed Pace Ailows Full Processing of the Material as It . . . . . 193
Ernerges and Avoids " Flooding " and Dissociation
6.2.6. The Use of a Body-Focused Approach Without Physical Touch . . . . 19 4
b y the Therapist Facilitates Integration
6.2.7. Drawing a Picture at the End of the Experiential Session . . . . . . . . . 198
Contributes an Additional Elernent to the Healing Process
7. DISCUSSION
7.1. Body Experiences of Women Survivors of Child Sexual Abuse: . . . . . . . . . . . 201
Refiections on the Findings
7.2. Implications for Therapeutic Intervention . . . . . . . . . . . . . . . . . . . . . . . . . 219
7 .3. Implications for Future Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
7.4. Limitations of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
7 .5 . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
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LET OF FTGURES
Mary's Drawing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Gwen's Drawing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Willo's Drawing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Trudi's Drawing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Laura's Drawing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
LIST OF APPENDICES
Appendix A Letter of Informed Choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 33
Appendix B Background Information Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Appendix C Interview Schedule
The Experiential Session . . . . . . . . . . . . . . . . . . . . . . 238
Appendix D Interview Schedule
Follow-Up Interview One Week Later . . . . . . . . . . . 2 42
Appendix E Interview Schedule
Follow-Up Interview One Year Later . . . . . . . . . . . . . . . . . . 243
ACKNOWLEDGEMENTS
To begin I would like to acknowledge the women survivors who so wiliingly gave their rime
to this project. Their sharing of experiences and insights so that others may l e m from them
is greatly appreciated.
A special thank you to Dr. Niva Piran for her encouragement to pursue this topic and
her guidance during the course of its development into a thesis. 1 also owe thanks to my
other dissertation cornmittee members, Dr. Lana Stermac and Dr. Bill Alexander, for their
assistance.
The results of what seerned to be an impossible task at the outset has been made to
look easy because of the invaluable help from friends and editors Ellen Shearer and Joanne
Close. 1 thank Ellen Shearer for her enthusiastic perseverance during the wnting of this
project. Her supportive presence and skill motivated me to further explore and elucidate the
matenal. 1t hank Joanne Close who copy edited this manuscript with exquisite attention to
detai1.
Finally, 1 thank my many other friends and colleagues who encouraged and supponed
me throughout this process.