Clinical Considerations for Adults Abused as Children

Abstract

Each year a great many children are physically, sexually, or emotionally abused. This early trauma often overwhelms coping mechanisms and derails personality development, resulting in childhood and adult psychopathology. Until recently, the connection between childhood abuse and adult psychopathology eluded most clinicians, with negative consequences for survivors. The author examines these phenomena and discusses a biopsychosocial and integrative clinical approach to this population.

Do Occupational Therapists Feel Equipped to Deal with the Adult Legacy of Childhood Sexual Abuse?

“…This led to preoccupation with internal events rather than with actual abuse and to negative and destructive consequences for the detection, assessment and treatment of survivors, who were revictimised by clinicians who suggested that their memories were fantasies (Wartel 1991). Survivors have encountered ridicule, disgust, disbelief and blame from professionals (Frenken and van Stolk 1990).…”

“…For survivors to risk disclosure, they must have confidence in the reaction they are likely to receive, especially as they may also have to overcome their own ambivalence or resistance to this process (R2, RB, Walker 1992). Thus it is imperative that therapists accept, believe and validate survivors' experiences, as well as fostering a sense of control, to counteract the inclination to flee therapy (Wartel 1991).…”

“…Most respondents thus believed that uncovering traumatic memories in timelimited settings was contraindicated. The focus was on coping, rather than uncovering, as a useful short-term strategy (Wartel 1991, Holmes 1995.…”