Trauma and Abuse Counselling

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TRAUMA AND ABUSE COUNSELLING

Case Study

1,750 words

Topic: Childhood Abuse

A lady, Hannah, now in her fifties, has come to see you. The perpetrator was her father, who was highly influential in the church. She (as well as several sisters) was sexually and emotionally abused between the ages of 9 and 16. As a child Hannah made several attempts to disclose the abuse but was unable to feel heard or believed. Hannah has attempted to tell a school nurse, a school friend. She has also approached the elders of the church, only to be told ‘we can’t discuss those things’. She is certain that her mother was aware of the abuse but would not talk about it. She has married twice, and has 4 adult children. Hannah has now approached you as a counsellor as her children are blaming her for their own difficult childhood. Hannah wants to forgive her father (now elderly and unwell) but feels caught between her own childhood family and her 4 adult children. How might you assist Hannah with her needs? Consider any ethical issues that may arise.

Introduction
The purpose of this paper is to explore and establish how I, as a counsellor might assist a client, Hannah, an adult survivor of Child Sexual Abuse (herein referred to as CSA) with her needs. Such needs will be identified and carefully examined in order to determine resources and strategies that will benefit Hannah as she works towards her goal of forgiving the perpetrator, her elderly father, while working though the issues concerning her feelings of being caught between her family of origin and her own adult children. She believes her mother knew the abuse was happening but was unwilling and unavailable to talk about it.

Further to this any ethical issues that might arise will be noted and appropriate responses explored. Hannah is one of several sisters who were all victims of sexual and emotional abuse. Although Hannah wishes to work toward forgiveness of her father her story is intertwined with that of other family members. This fact may raise ethical issues and challenges. Damage of Child Sexual Abuse

Abuse removes from a person the freedom to choose, leaving behind an overwhelming sense of powerlessness. For children there is a definite and normal power imbalance between themselves and the adults charged with their care. When an adult abuses this power imbalance by sexually assaulting the child, more often than not a deep wound results. The child has an innate sense that something is wrong, and longs for a ‘normal’ family, often investing enormous amounts of emotional energy trying to cope with the dysfunction within the family system (Allender 1995, pp. 114-118).

This sense of powerlessness leads to frustration and eventually despair, loss of sense of pain, sense of self, sense of judgement and sense of adequacy. Over time there develops a deep doubt and self-hatred along with an inability to appreciate and value the self, or to receive appreciation and value from others. The person rejects the self and the acceptance of others, while deeply longing for that acceptance (Allender 1995, pp. 119-126).

Betrayal is devastating, typically promoting hypervigilance, suspiciousness, distortion and denial (Allender 1995, pp. 134-135). Hannah has suffered the ultimate betrayal by her father. Her father enjoyed an elevated level of community trust due to his leadership position in the church. Allender states ‘Because it seems inconceivable that a man or woman may be a respected servant in the church by day and an abuser by night, such situations are even more possible (1995, p. 132). The parent/child relationship was violated, leading to shame and self-blame.

Further to betrayal is failure to nurture, and lack of protection from the nonoffending parent, her mother. In Hannah’s case this could have been either chosen neglect or denial. According to Allender ‘A parent does not need to know about or suspect sexual abuse to betray a child’...
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