Treating Adult Survivors of Severe Childhood Abuse and Neglect: Further Development of an Integrative Model (From The APSAC [American Professional Society on the Abuse of Children] Handbook on Child Maltreatment, Second Edition, P 175-203, 2002, John E.B. Myers, Lucy Berliner, et al., eds. -- NCJ-19

• NCJ Number: 198707
• Author(s): John Briere
• Date Published: 2002
• Length: 29 pages
• Sale Source: Sage Publications, Inc
• Publication Format: Book (Softbound)
• Publication Type: Literature Review
• Language: English
• Country: United States of America

Annotation

This chapter synthesizes current dynamic, cognitive, and behavioral approaches that have been found helpful in treating adults who have experienced trauma from severe abuse in their childhoods.

Abstract

The integrated model described is based on a theory that incorporates aspects of trauma theory as well as cognitive, behavioral, and self-psychology theory. The model expands the cognitive components of self-trauma theory, incorporating newer concepts in the areas of suppressed cognitive activation, relational schemas, and the role of early attachment experiences on thoughts, feelings, and memories. For the purpose of discussion in this chapter various types of maltreatment are characterized as acts of omission and commission. A section on abuse-related symptom development addresses preverbal assumptions regarding self and others, conditioned associations between abuse stimuli and emotional distress, implicit/sensory memories, narrative/autobiographical memories, suppressed or "deep" cognitive structures, and interference in the development of affect regulation/tolerance skills. A separate section of the chapter considers the nature of posttraumatic stress, followed by a section on intrusive sensory and cognitive symptoms as memory processing. A discussion of the treatment implications of the self-trauma model addresses treatment process issues and the therapeutic "window," exploration versus consolidation, intensity control, goal sequence, intervening in impaired self-functioning, safety and support, facilitating self-awareness and positive identity, self-other entitlements and boundary issues, affect modulation and affect tolerance, and disturbed relatedness. Remaining sections of the chapter focus on intervention in abuse-related posttraumatic symptoms, processing and resolution, and access to previously unavailable material. Taken together, the elements of the self-trauma approach outlined in this chapter allow the therapist to address the impaired self-functioning, cognitive disturbance, and posttraumatic stress found in some adults who were severely abused as children. 65 references