Published articles by Rebecca Mitchell on issues around sexual abuse
Supporting Clients During An Abuse Disclosure
By Rebecca Mitchell from Into The Light (www.intothelight.org.uk)
First published in the ACC Magazine Accord: Spring 2013
“I’ve never told anyone this before…” As soon as a client begins to say this you know you are on hallowed ground. If you get to that place with a client the chances are you are doing a very good job – but even so it is not an easy place for either counsellor or client.
So much hangs in the balance. It may have taken the client months, years, perhaps even a life time to come to this place to share a secret they may consider so dark, so shameful so deadly even. In the wake of the Jimmy Savile scandal the number of sexual abuse victims calling charity helplines has vastly increased. It seems the coverage over Savile’s crimes gave other victims the courage to come forward. The National Association for People Abused in Childhood (NAPAC) said it usually receives 200 to 300 calls a week, in the three weeks following the Savile revelations they received 2,500. Peter Saunders from NAPAC said: “We’ve seen an unprecedented deluge of callers, people making contact with us, survivors of abuse telling us about stuff that’s happened to them, mostly a long time ago”. (Source: BBC News website: 24/10/2012). In reality, this could mean that as more Survivors of abuse come forward for help, you as a counsellor may well find yourself listening to traumatic disclosures that have been hidden away for years shrouded in shame and secrecy.
Fear Of Judgement
One huge issue that may stops a client from disclosing is fear of judgement. This is illustrated clearly in a problem page letter in “The Guardian” to the Psycho-Sexual Counsellor and Writer Dr Pamela Stephenson. The reader had written in with a very traumatic childhood sexual memory that she felt she could not even share with her counsellor.
“I can’t talk to anyone about it as it is such a taboo. I have started seeing a counsellor, but I am worried that people will judge me for being a bad person” (The Guardian 2nd November 2012)
I can so identify with this. As a Survivor of sexual abuse (and also a Professional working with Survivors for many years) I have been in and out of counselling for over twenty five years yet even I never felt safe enough to reveal some abuse memories that were really troubling me. Finally, due to the security I felt with my counsellor and the stress of holding onto my secret – I could contain it no longer. Although it probably only took minutes it felt like hours and I actually thought I was going to pass out the stress of the disclosure was so intense.
For a client to be able to share something they considered as off-limits as this you are likely to counteract a huge wall of shame. “Shame exists in an environment of secrecy.” (Source: “Courage To Heal” by Ellen Bass and Laura David: Published by Cedar 1988: Page 108) To overcome this shame then, the client must experience “your consistent warmth and unconditionally of regard” which can enable to bring clients who have suffered trauma and distress “to the point of trusting.” (Source: Person Centred Counselling In Action: Mearns and Thorne: Published by: 1988 Sage: Page 106). With that in mind, you may have to re-assure the client over and over again that however dark their secrets – you remain open and with total acceptance and warmth towards them. My own counsellor certainly did.
But once the door is open how as Counsellors – are we meant to respond?
Doreen Fleet in an article called “In The Deep” in the BACP Private Practise Magazine (Summer 2012) explains how she and her client were able to be together with each other during a very painful and distressing disclosure about sexual assault. Her client had come to the place that she felt the “unspoken had become so fearful that the only way to combat it was to speak of it” and she bravely felt that she “had to say it loud once” but at the same time was anxious about her therapists response: “I don’t know whether you want to hear it”. Doreen Fleet goes onto say that “absolute honesty and transparency was essential” on her part and she gave an authentic yet reassuring reply “I don’t know how I will be, but I want to stay with you, help you to do what you need to do. I hope I am able to do that”.
Being There For The Client
Of course there is no “script” for how to “be” with a client when they are re-calling trauma but some assuring interventions could include perhaps:
- What do you feel you need from me right now?
- I want to stay with you in this…what would help you to know that I am?
Many people when recalling a traumatic incident, especially when they have been the victim, for complex reasons blame themselves for what happened . Some interventions that might be helpful could include:
- “I’m so sorry … you never deserved that”
- “I see the blame on… not on you.”
However, a client may well not be able to hear that you do not see them as to blame – you could also go with them for a while into their world if they are struggling with false guilt perhaps asking:
- “Could you explain to me why you think you are to blame”
You also need to be prepared to listen fully to the story before you attempt to challenge it. If you interrupt before the story is over then the client may well think you haven’t heard the whole story and therefore “if they knew this bit or these details they would also know I was to blame”. So, in order to make sure they have finished you could ask a gentle question “Its OK to tell me anymore…?” You could challenge with a question perhaps in order to help them to see things in a different way:
- “I am wondering if someone told you that?”
- “Who was leading and who was being led”
- “What was your objective when you met this person”
- “What other choices did you have”
It is important to remind the client especially if there were exchanges ( e.g. money, affection, gifts) what their original intention was and what the abuser’s original intention was.
Some questions you might like to consider could be:
- Who originally initiated things?
- What was your fundamental motive when you met this person?
- What do you believe was the abuser’s original motive?
- Realistically who could you have told who would have helped you?
- What would you say to another vulnerable (or young) person who told you they were being abused?
Keeping Yourself Grounded
Being with someone who is re-telling trauma is not easy as a Counsellor.
It is demanding, exhausting and can be extremely stressful. However, Maggie Ellis Founder of “The Life Centre” A service for Rape victims in Sussex gives some excellent guidance in her training on listening to trauma. She stresses the importance of keeping yourself as the Counsellor grounded in your own reality – as well as making the client your total focus.
Some pointers include:
- Adopting a posture that doesn’t mirror the client’s posture that will work to counter act any trauma you may be picking up.
- Being aware of your feelings during and after hearing a traumatic story.
- Controlling your feelings so you are not feeling the client’s experiences with them.
- Being aware if any words trigger your own experiences – imagine a wall separating you from their story. Imagine sitting on top of the wall listening and supporting them but leave their feelings and yours down below.
- When listening to a story don’t personalise it to you or your family or friends.
- When listening to a story that is very sexually or violently graphic do not picture it.
- Pacing yourself and your client.
- Visualise a box you can put the stories in and shut the lid.
- Don’t give rein to the imagination to take over.
- Look at something beautiful outside afterwards e.g. the sky.
- See the survivor in the client- respect their strengths.
- Actively practise self care and keep your life balanced.
- Handing over the story to God.
(Source: Based on ideas from “The Trauma of Rape and Sexual Abuse”: Maggie Ellis: ACC SE Conference Notes June 2004 and put into my own words)
If A Client Enters A Flashback
Sometimes when a client is re-telling a traumatic memory or incident they can go into a “Flashback.”
Flashbacks occur to people when they have experienced a traumatic incident and are the memories of that trauma that have not been processed. The World Health Organization (1992) describes post-traumatic stress disorder (PTSD) as a “Delayed or protracted response to a stressful event (of either brief or long duration) of an exceptionally threatening or catastrophic nature… Typical features include episodes of repeated reliving of the trauma in intrusive memories (‘flashbacks’)”.
During a “flashback” clients can lose touch with the here and now and with their current selves, they may look very distant and out of touch with you as a counsellor and may even say things in response to the flashback. There is a blurring between past and present – and this can feel extremely frightening for the client – and can be alarming for you as a counsellor as well. If this does happen, stay calm and do what you can to reassure them and see if you can together use Grounding Techniques (see below).
The flashback will eventually stop and once it is over help the person get back into the here and now. It is probably too soon to talk about the flashback. However, encourage the client to later write it down and bring it back to the next session so you can process it together. “Flashbacks are fragments of memory that have not be properly encoded into the memory system… writing it down what is remembered and talking it through in counselling can enable the memory system to re-encode and re-integrate this piece of traumatic memory.” (Source: The Trauma of Rape and Sexual Abuse”: Maggie Ellis: ACC SE Conference Notes June 2004).
One way you can help your client if they are experiencing a Flash back is to help them to “Ground” themselves this means they actively bring themselves from the past memory into the current day:
Here are some tips for “Grounding” a client:
Feet First:
Ask the client to stamp their feet on the floor reminding themselves of the here and now.
Breath Deep:
Ask the client to become aware of their breathing. When we are fearful we can start to breath very quickly. Take a few minutes to just breath in and out slowly with the client. Count out loud if that helps e.g. four counts in and six counts out.
Use Senses
Supporting the client to use their senses can help them into the present: Look: Ask the client to take in the shapes, colours of the room you are both in
Listen: Ask the client to listen to everyday noises around – traffic outside, a bird singing perhaps voices in the corridor
Feel: Ask the client to feel the chair they are sitting in, a cushion to stroke their hands and say what it feels like. This will re-engage their brain to correct with their physical body.
Remind The Client :
This is just a memory – this is not actually happening. Remind the client The worst is over and help them focus on who they are now. If it helps talk to the frightened “child” part of the client and get them to do the same and assure him or her that the client in their healthy adult self can take care of him/her now. If the flashback is severe they may need to help to be able to do this.
The Consequences Of Disclosure
Sessions which contain disturbing material are not easy for either counsellor or client – but for Doreen Fleet in terms of her client it was a breakthrough moment. After the disclosure Doreen Fleet says she noticed that “something had shifted in her. In subsequent sessions her posture was different, more confident, her voice was more assertive and she had stopped being triggered by the “Object” related to the attack.” She was not what you would call “Cured” …but this was one battle she had won and it made a difference.”
I can also say after the particularly painful session when I was able to talk about an aspect of the abuse I had never shared before – I didn’t feel like my whole life changed in a magical moment – but I did feel different. I felt the shame shift and I began to see the situation and importantly myself in a newer, more positive light.
As a Professional too working with Survivors, I have sat with clients on countless occasions when they have bravely talked about their past harrowing memories for the first time. I have seen myself that however excruciating the disclosure the rewards afterwards in terms of confidence, communication and (interestingly) self care are immense.
It is not only a client whose life changes after such an intense experience – as a counsellor your own life too will be impacted. Doreen Fleet shares that afterwards she felt she “had been to another person’s darkest place and managed not only to stay with her but also help her to move through it” and because of this reveals “I felt a change in me.” (Source: BACP Private Practise Magazine: Summer 2012)
In spiritual terms there is no way we can look at violation and abuse as anything other than a work of darkness. But perhaps the light is there too if we look hard enough. Not that God wants anyone to endure such immense suffering, but perhaps out of a such distressing situations some hope can come – and not just for the victim either. But this can only happen when there is the space and understanding for clients to feel confident enough that those “taboo” secrets they are carrying that they feel they “can’t talk to anyone about” can finally be spoken out and brought like “shadows into the light”.
Sources:
“Courage To Heal” by Ellen Bass and Laura David: Published: Cedar 1988: Page 108
BBC News Website: 24th October 2012
Person Centred Counselling In Action: Mearns and Thorne: Published by: Sage: 1988 Page 106
“In The Deep”: Doreen Fleet: BACP Private Practise Magazine: Summer 2012 Page 26
“The Trauma of Rape and Sexual Abuse”: Maggie Ellis: ACC SE Conference Note: June 2004
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