Psychoanalytic Psychotherapy After Child Abuse: The Treatment of Adults and Children Who Have Experienced Sexual Abuse, Violence, and Neglect in Childhood

147 Pages·2008·0.94 MB·English

by  Daniel McQueen

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6 PSYCHOANALYTIC
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PSYCHOTHERAPY AFTER
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PSYCHOANALYTIC
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PSYCHOTHERAPY AFTER
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9 CHILD ABUSE
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2 The Treatment of Adults and
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Children Who Have Experienced
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Sexual Abuse, Violence, and
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7 Neglect in Childhood
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2 Valerie Sinason, and Fay Maxted
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5 First published in 2008 by
6 Karnac Books Ltd
7 118 Finchley Road, London NW3 5HT
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Copyright © 2008 Daniel McQueen, Roger Kennedy, Valerie Sinason, and
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Fay Maxted
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The rights of Daniel McQueen, Roger Kennedy, Valerie Sinason, and Fay
5 Maxted to be identified as the authors of this work have been asserted in
6 accordance with §§ 77 and 78 of the Copyright Design and Patents Act
711 1988.
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9 All rights reserved. No part of this publication may be reproduced, stored
20 in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise, without the
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prior written permission of the publisher.
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British Library Cataloguing in Publication Data
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A C.I.P. for this book is available from the British Library
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7 ISBN: 978 1 85575 639 7
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311 Edited, designed and produced by The Studio Publishing Services Ltd
1 www.publishingservicesuk.co.uk
2 e-mail: [email protected]
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www.karnacbooks.com
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111 CONTENTS
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211 ACKNOWLEDGEMENTS ix
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ABOUT THE AUTHORS xi
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3 THE GUIDELINE DEVELOPMENT GROUP xiii
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PREFACE xvii
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Introduction 1
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Purpose of this guideline 2
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What is psychoanalytic psychotherapy? 2
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Government policy context 3
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Key messages 5
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Recommendations 7
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Background 11
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Extent of the problem 11
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The context of abuse 13
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Symptoms and effects in childhood 16
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Later symptoms and effects 17
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Memories of child abuse 21
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vi CONTENTS
111 Child abuse linked to spiritual or religious belief 23
2 At risk children 24
3 Children with disabilities 25
4 Socially excluded children 29
5 Childhood First 30
6 Trafficked children 36
7 Under-reporting 38
8 Online abuse 39
9 Gender, violence, and abuse 40
10 Gender and domestic violence 40
1 Gender and child sexual abuse 41
2 Adolescents and children who commit child 43
3 sexual abuse
4 Attachment, trauma, dissociation, and the developing 44
5 brain
6 Attachment 44
711 Reflective function 45
8 Insecure and disorganized attachment 47
9 Trauma and dissociation 48
20 Attachment in adults 50
1 Dissociative disorders 51
2 Post traumatic stress disorder 53
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4 The journey 55
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6 Psychoanalytic treatments 63
7 Evidence 63
8 Researching psychotherapy 64
9 Children who have been sexually or physically abused 66
311 or neglected
1 Adults who have been sexually or physically abused 67
2 or neglected in childhood
3 Evidence for psychoanalytic psychotherapies 69
4 Cassel Hospital 70
5 Stepped care 71
6 The process of psychoanalytic psychotherapy 76
7 Affect-regulation 76
8 Patient–therapist interaction 78
911 Modification of technique 79
CONTENTS vii
111 Assessment 80
2 Safety 82
3 Training 83
4 Psychoanalytic psychotherapist training 83
5 Training for child psychotherapy 84
6 Supervision 84
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8 Services 87
9 SARCS 87
10 Independent and voluntary sector 88
1 Examples of independent, voluntary and 88
2 survivor organizations
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REFERENCES 97
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5 INDEX 117
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211 This guideline is the product of collaboration between a wide num-
1 ber of individuals and organizations concerned about the effects of
2 child abuse and neglect, and the challenges of providing timely,
3 appropriate, and effective therapeutic help.
4 The group responsible for developing this guideline was con-
5 vened by Catherine Itzin, working at the Department of Health as
6 Director of the Victims of Violence and Abuse Prevention Pro-
7 gramme, and Policy Lead on Sexual Violence and Human Traf-
8 ficking and on Domestic and Sexual Violence and Abuse. Roger
9 Kennedy, as President of the British Psychoanalytical Society, was
30 invited to chair the group. Susie Orbach, Professor of Sociology at
1 the London School of Economics, co-chaired the group. Experts on
2 child abuse and psychotherapy were invited from many fields:
3 experts by experience, survivor groups, academics, activists, and
4 clinicians (including paediatricians, physicians, child and adult
5 psychiatrists, psychoanalysts, psychologists, and psychoanalytic
6 psychotherapists). The Guideline was written after four meetings of
7 the group and copious exchanges of e-mail.
8 Some individuals involved in this project stand out as deserving
911 of special acknowledgement: Catherine Itzin, whose vision created
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