Bonnie Bazill-Davis, BA Speaker/Trainer in Child Abuse Awareness Speak Out Services, LLC “Education that Saves Lives” • Problems are firmly rooted in today and not the past • Time of “maintenance” are recognized and embraced for healing • Healthy boundaries have been established with offenders/deniers • A sense of self-worth is restored • Healthy “tools” are employed to handle life’s emotional states • Peace has been achieved over the experience – it loses its power to dominate/control your life • Definition of Sexual Abuse and Indicators • Test Your Knowledge Bingo • A Shoe Story of Incest • Five “A’s” of Recovery Awakening, Absorbing, Alleviating, Accepting, Advocating • How to Help Kids • Your Five “A’s” – Applications for Practice Sexual activity which may be touching or non-touching performed on a child for the gratification of the perpetrator. Ohio age of consent is 16. Incest is sexual abuse perpetrated within a family system, including friends of the family. SIA defines incest as sexual abuse including a betrayal of trust. All childhood trauma or excessive stress has some common indicators including: • Falling behind developmentally and/or academically • Inability to focus attention • Personality or mood changes • Regressive behaviors (thumb-sucking, wetting, etc.) • A knowledge of sex acts or language beyond developmental level • Acting out in a sexual way with other children or toys and is unable to stop behavior when re-directed • Excessive masturbation, may again be unable to follow re-direction • Excessive washing • Unusual fears or anxieties – bathrooms, changing clothing, certain people, etc. • Eating disorders • Difficulty walking, stained/bloody underclothing, STD’s, early pregnancy • Randomly write the numbers 1 – 9 in the boxes on your card • The numbers on your card correspond to the number of questions • Give yourself an “X” for every correct answer • Yell “BINGO” for a prize! True or False: All children will experience sexual abuse as traumatic. True or False: Dissociation, the perceived detachment of the mind from the emotional state or the body, occurs naturally in most people. True or False: Forgiveness is the ultimate goal of the recovery process. True or False: All survivors should confront their offenders at some point in the recovery process. True or False: Psychological trauma can lead to physical changes in the brain. True or False: All children who experience sexual abuse will need therapy. True or False: It is possible to recall an earlier abuse experience without an actual “picture” memory. True or False: Parenting methods that focus on positive interactions will help reduce the symptoms of trauma in children. True or False: Art and play therapies have some distinct advantages for abused children. Climbing the ladder to the light is a PROCESS and not an event! • May be full or partial awareness with or without actual visual mental pictures of abuse • May be sensory imprints • Awareness may be sudden or gradual • Awareness and recognition of effects may be ongoing throughout life Implicit Memory “Feelings/Sensations” • Non-conscious and non-verbal • Emotional, senses • Procedural (driving a car) Explicit Memory “Movie-in-Your-Head” • Conscious • Verbal • Contextual Memories in a Box A study of 46 subjects with PTSD indicated that traumatic memories were retrieved, at least initially, in the form of dissociated mental imprints of the traumatic experience including: •Visual •Olfactory (smells) •Affective (feelings/knowledge) •Auditory •Kinesthetic (body) Van der Kolk, B. A., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress, 8, 505-525. In a study of 129 women who had documented forensic evidence of child sexual abuse the following was found during interviews 17 years later: •38% had no recall of the sexual abuse •Under the age of 7 •Abused by someone they knew Journal of Consulting and Clinical Psychology 1994, Vol. 62, No. 6, 1167 - 1178 The hippocampus is involved in learning and memory processes. Adult trauma survivors have shown significant decreases in the size of the hippocampus, helping to understand memory complications. Bremner, J. D. (1999). The Lasting Effects of Psychological Trauma on Memory and the Hippocampus Yale University School of Medicine. Leadershipcounil.org • Chemical dependency is common for trauma survivors • Chemicals help to numb emotional pain • Sobriety important to recovery processes • For some, treatment for chemical dependency may need to include therapy for sexual abuse to prevent relapse National Institute on Drug Abuse, NIDA Notes, Vol. 17, Number 1 April 2002 Make this go away - I want my apple back!!! • Group involvement to understand that others have similar experiences • Fear for sanity and mental health • May have no “evidence” or family who supports memories • With incest, changes to family relationships and feelings toward family members • No good options – “I’m nuts or my father is a child molester” Processing Emotions Art Therapy – Emotions Run Amok • Outlets for anger and rage, which may need physical release • Grief, loneliness, and loss of family (important to develop family of choice) • Anxiety/panic and depression • Blame and shame - “we were fine until you messed it up” • For incest, strong mechanisms of denial within the entire family system • Self-blame • Self-hatred, loathing • Begins pattern of “victim thinking” in multiple life settings (relationships, work, finances, etc.) • Uncertain of “normal” Abuser Non-Offending Parent Target Trauma-Focused Cognitive Behavioral Therapy (adults & kids) involves: • Education to normalize the effects of abuse • Affect regulation and relaxation to cope with feelings and self-soothe • Overcoming learned fears of trauma reminders • Helping the survivor construct a non-distorted trauma narrative to tell a coherent account while connecting their thoughts, feelings, and behaviors. Play Therapy can be form of TF-CBT for children and uses sand trays, art, toys, and games in sessions to help children recover from the trauma. Benefits are: • Kinesthetic involvement – touch and feel • Dichotomous thinking – helps examine all or nothing thinking • Symbolic communication – helps with children’s fear of telling Goodyear-Brown, Paris, LCSW, RPT-S, “How Children Tell: Non-Linguistic Narratives in Trauma Work with Children” APSAC Colloquium, July 2011. Hypnotherapy The subconscious is accessed through deep relaxation in the therapy session. EMDR Eye Movement Desensitization and Reprocessing therapy helps the client access the traumatic memory network via eye movement exercises facilitated by the therapist. • Affirmed my strengths, did not emphasize labels, and above all else, listened • Were not afraid of my rage and gave me an outlet for expression • Offered art therapy and Gestalt techniques, such as “empty chair” exercises • Encouraged my involvement in groups, both therapy and outside support groups The Tangled Web Physical Boundaries Lack of control over your own body Lack of escape from abusive environment Emotional / Mental / Family Role Caretaking of perpetrator (with incest) Spouse/daughter role reversal Sexual / Touch Boundaries Confusion between normal touch and sexual touch Lack of healthy sexual boundaries as teenager/adult Sex/love confusion Spirituality is a complicated issue for many survivors with many faucets including: • Cultural depiction of God as male and some experiencing abuse by a man • Fearing God as angry and hurting those who do not obey • Sexual abuse may have had religious connection for some such as clergy abuse, cult abuse or extreme religious righteousness by the offender or denier/caregiver. How Do You Define It? How do you forgive someone who has never asked for forgiveness or owned the behavior? • Only achieved after doing the emotional work and seeing the power balance “shift” in our relationship. • Development of empathy towards my father. • Creating new definition for forgiveness – not “forgive and forget” • Agreeing to disagree – accepting that I would never get an apology for the abuse, but accepting “lesser” apologies as enough. Finding Meaning from Pain • Report suspicions • Believe children when they disclose yet be cautious of asking leading questions • LISTEN and PLAY • Educate to dispel mental distortions and set healthy boundaries • Be cautious of touch with sexually abused child • See the child as strong – strength-based approach • Provide sincere positive support and statements in 80% of interactions • Provide safe place so child can calm self • Provide creative outlets for feelings • Offer choices for regaining power Your five applications or insights gained from this workshop! Questons? For a list of additional SOS trainings visit: www.speakoutservices.com 937.371.9923 Bonnie@speakoutservices.com