Sexual abuse, self-harm and self-care
Many of the clients I have worked with have experienced sexual abuse as children. One of the common themes that arise during counselling is the feeling of being disconnected from their body. Feeling numb and or denying any psychological feelings good or bad. Often, this leads a client to self-harm to enable them to first, feel something physical in their body, and second, to be able to care for their hurt body. It is almost as if the client only feels able to self-care when they experience physical, visible pain. Maybe seeing a wound and blood being released is enabling them to have permission to care for themselves. Reconnecting them to their body.
A visible wound will elicit expressions of concern from society, unlike a psychological wound which cannot be seen and, even if expressed by the client, may be dismissed or minimised.
However, typically a client who self-harms will make sure they do it in a non-visible place. Clients do not seem to be able to accept sympathy or compassion for their behaviour. It goes against their own feelings of self-disgust and self-hate. Almost replicating the perpetrator's behaviour and feelings towards them.
Being sexually abused means being treated as an object, dehumanised. The perpetrator has no empathy or compassion for their victim. Their purpose is solely selfish: to gain control and power over the victim. Any grooming that is done is with the intention to cause harm. Apologising after the assault will normally be in order to keep the victim quiet and ensure they don’t get caught. It may also be a way of manipulating the victim for repeated abuse.
Shame is a powerful feeling which helps to keep the client silent for many years. Many clients tell me it is the first time they have told anyone what happened to them. Many cannot speak and we have to find different ways to enable them to tell their story. Fear of being rejected by society for what happened to them is common.
As an adult, looking back on what happened to them as a child can take on a perspective which is unfair to them. They are reviewing and assessing what happened with an adult’s brain. The developmental stages of a child dictate their understanding of the world and how much power and control they have in it. Clients blame themselves for what they did or didn’t do, forgetting the implications this may have had on them as a child. They forget that they may not have been believed, may have tried to tell and been dismissed, or that the abuser may have threatened them or their families.
As a child, the reasons for not telling are more than convincing than the ones for telling. For example, if they are dependent on the abuser for survival (i.e. for food, shelter etc), by telling, aren’t they risking their very survival? If the abuser is arrested, the child may think their food and shelter will also be gone (never mind what the abuser might do to them in revenge). They may not know about support services available and may fear losing everything else in their world.
To alleviate the symptoms of sexual abuse each client’s counselling will be tailored to them. However, commonly, learning how the brain reacts to trauma and applying this to the client’s situation can help them understand more about their behaviour, thoughts, and feelings. Also, understanding how the body needs to be cared for after being triggered or having flashbacks can be useful in reconnecting with the body. For example, going for a walk/run should reduce stress and lower cortisol levels.
Self-care and self-compassion are two of the hardest things to achieve for a client. Gradually over time, the counsellor and client can build up a list of self-care activities which the client can refer to. Applying these will be beneficial and will put some power and control back in the client’s life (which is often lacking).
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