Not Trauma Alone

by Steven Gold

How is an individual to lead a comfortable, productive existence when he or she was never taught the skills necessary for effective living? Adult survivors of child abuse often face this dilemma. Instead of being nurtured as children and taught life-skills by their caregivers, child abuse survivors were subjected to a daily regimen of coercive control, contempt, rejection and emotional unresponsiveness. It is not surprising, therefore, that many survivors encounter difficulty adjusting from this type of damaging childhood atmosphere to one in which they have autonomy. This book addresses the particular problems associated with treating adult survivors of child abuse. Until now, psychotherapy for child abuse survivors often centered on the trauma of their abuse experiences. However, survivors frequently reveal a history suggesting it was not abuse trauma alone that created their difficulties, but growing up essentially alone - without the consistent emotional support and guidance needed for development of effective functioning. This book presents an alternative to trauma-focused treatment that, though effective for treatment of other forms of trauma, can induce deteriorated rather than improved functioning in survivors of prolonged childhood maltreatment. The contextual therapy presented in Not Trauma Alone delineates a psychotherapeutic approach that emphasizes helping survivors develop the capacities for effective functioning that were never transmitted to them during their formative years. Detailed descriptions of the methods and interventions comprising contextual therapy are included in this critical book for all mental health professionals, clinicians, academics, and students in the field.

Genres: Psychology

302 pages, Hardcover

First published June 21, 2000

Reviews

[Sheryl · Rating 5 out of 5]

This book is addressed to therapists but can be helpful to survivors as well. The language does get somewhat technical sometimes and it was not written in a particularly supportive tone, but OTOH it can be helpful in seeing that some responses are common to those with similar backgrounds, rather than being evidence of the survivor's supposed unworthiness. It also bluntly states some truths that survivors sometimes struggle to put into words, which can be a good thing if the survivor is ready to fact that truth.

In particular, Gold points out one thing that many abuse survivors would rather not think about; that "many of the problems manifested by survivors may have their origins in... family context, rather than solely in the discrete incidents of abuse." Particularly when the most overt or dramatic abuse happened outside of the family, some people would rather focus on that and "work it through", even when it becomes clear that, in their case, "Overt incidents of abuse merely comprise a single component of a much more pervasive childhood atmosphere of coercive control, contempt, rejection, emotional unresponsiveness, and a lack of training in those fundamental abilities necessary for effective daily living that for most of us are so second nature we do not even realize they are learned."

Notice the lack of obvious-to-outsiders abuse in that list. While many abusive families are the cliche on TV -- chaotic, where the house is a disaster and some family members drug addicts and in and out of trouble with the law -- some are controlling, where everything looks perfect to the outsider. And the children of those families have often been taught that maintaining that look of perfection is more important than their own psychological health, meaning it can be hard to admit that their parents "groomed" them for the outsider abuse. But while it's possible for children from healthy families to be abused by outsiders, generally it is the "excessive degree of conflict and control, and a deficient level of cohesion, adaptability, and nurturance" at home that makes them vulnerable to it. Gold believes it is more important to focus on recognizing and replacing that lack than to focus on "remembering and processing" particular traumatic events.

Since "people who grow up abused, neglected, disregarded and abandoned as children are as adults at extreme risk for continued invalidation and mistreatments by society at large," Gold believes the first focus must be on helping people to cope with their current situation and to recognize abuse when they're dealing with it. This means that sometimes people remember specific events of childhood abuse as they connect into current events, and they go back to work through those past events quite directly, but also that sometimes people finish their therapy without even have worked at clarifying memories of abuse, because it has not been necessary. Facing the past events and pulling up every detail is not always necessary in order to repair the damage they've done. OTOH, focusing on remembering and coping with childhood abuse before the person has learned the coping strategies or gotten grounded in the idea that they deserved better can be counter productive: increasing their depression or increasing their flashbacks or otherwise lowering their ability to cope with their current lives.

There is no one, magic formula for coping with abuse; Gold's methods are ideal for some and worthy of consideration when the "trauma model" is not working, and especially when trying to "work through the memories" is making things considerably worse.