Harley Street Counselling - Childhood Abuse

Let me begin by making clear that I do not work with abused children. That work requires very specialised skills which I do not have. What I am concerned with, and this short article is about, are the adult survivors of childhood abuse.

Abuse experienced in childhood may be emotional, physical or sexual. If there has been one of these there may well have been the others too. The effects of abuse in later life, when the abused child becomes an adult, range from mild to life threatening. In my experience there is always an effect of some kind. The factors which seem to be relevant to how severely the abused person will be affected include:

the age at which the abuse took place,
how long it continued,
the seriousness of the actual abuse (e.g. in the case of sexual abuse it could range from inappropriate comments to touching or penetration),
the manner in which it was carried out (e.g. by trickery and cajoling or by using force and violence),
where abuse took place (most damaging would usually be if it took place in the child's own home or bedroom),
the abuser's relationship to the abuser (the closer the relationship the more damaging the abuse),
was the child able to get support from any other non-abusing adult?

Adults who have been abused frequently have difficulty in trusting and this often makes it difficult for them to maintain relationships - especially intimate relationships. If they have been sexually abused they may find adult sexual relationships impossible or, alternatively, they may find that sexual relationships are the only kind of relationships they can have. Almost universally the abused person feels that it was their fault that it happened: even though they may be perfectly clear in their minds that they were abused by an adult, they still FEEL, deep down, as if they were responsible themselves.

When working with adult survivors of childhood abuse the first priority must always be to avoid causing further harm This can occur, for example, if the therapist pushes the client too hard to re-live the childhood trauma before they are fully prepared for this. The effect then is not the hoped for new insight leading to repair of the damage but simply further trauma - the client can experience it as simply a repetition of the original events.

To work successfully the therapist and client must form an effective alliance based on a mutual respect. The client has to know and feel that in the therapy room he or she has full control over his or her own life. S/he has to know that s/he can say "No." to the therapist and that that "No." will be respected.