Sexual and Physical Abuse/Assault Counselling
A major piece of my trauma work involves treating sexual and physical abuse/assault, suffered both as a child and as an adult. I understand that it takes a great deal of courage and resolve to work through these events in therapy. I treat you with the sensitivity you are owed given the gravity of what you have been through and continue to go through.
The overall goal of the treatment is to resolve or significantly reduce the trauma symptoms associated with the abuse/assault event(s). This is done primarily by desensitizing the memory of the event with EMDR (Eye Movement Desensitization and Reprocessing). After deeply processing the past it no longer intrudes in the present. You come to reinterpret what happened to you in a self-loving and rational way: I am not at fault here.
Along with a fuller assessment, I will take a history of your life traumas (and blessings) and with you make decisions about which abuse/assault events to target and target efficiently. (“Efficiently” might seem a strange word here but you want the therapy to work and you don’t want it to go on forever.)
Because the work is usually challenging and because most clients are already living with profound symptoms, I will first make sure you are using grounding practices to manage your trauma symptoms—both when they arise in session and during your everyday life. The practices I’ll show you combine breathing, soothing, mindfulness, cognitive, and orienting (to the safe here-and-now) exercises.
I will also encourage and support you to have healthy structures in place while in treatment. Such structures might include regular exercise, healthy diet, regular conversations with safe friends and family, meditation, yoga, 12 step groups, and reminders to remember your practices and structures.
I will give you psychoeducation about trauma and the brain/body so the practices and EMDR treatment make more sense to you.
For the desensitization of the traumatic event, I use EMDR [LINK TO my EMDR page]. While following a light (on a light bar) or with another form of bilateral stimulation, you will re-experience but now (more) fully process the abuse/assault event. The processing, especially in the early stages, can be vivid and disturbing. However, unlike with the actual experience of the event, you will know the event is not happening now; you will know you’re helping yourself and not helpless; and you will be supported by a trained professional affirming your fundamental dignity and intervening when appropriate.
FREQUENTLY ASKED QUESTIONS:
How long is the treatment?
If the abuse/assault event is a single trauma, unrelated to any earlier traumas, the work can be completed in as few as one or two desensitization sessions (with prep sessions also needed). Generally, the greater the number of traumas and the earlier in childhood they occurred the longer the treatment. A person with years of childhood abuse would likely require 20+ sessions of treatment. All the work, however, does not need to be done at one time. And you could do just a “piece” of work if you choose to.
Am I hypnotized during EMDR desensitization?
No. With hypnosis you are in an altered state of relaxation and receptivity differing from ordinary reality-oriented states. Contrary to that, with EMDR you are often in a heightened reality-oriented state. At the same time you are vividly remembering a past event—thoughts, feelings and body sensations–your rational and loving adult self is observing your remembering, all the while knowing you are presently in your therapist’s office taking care of yourself.
Does the EMDR desensitization always go smoothly?
No. Some clients, particularly early in treatment, experience considerable hyperarousal (usually fear) and/or hypoarousal (dissociative symptoms). As an EMDR clinician, I am trained to deal with these situations. Sometimes I delay desensitization for many sessions until the client is ready: stabilized with effective grounding practices. And sometimes, with desensitization initiated but with significant disturbance and/or dissociation persisting, I proceed very slowly, using appropriate interventions.
Do I have to do the EMDR desensitization as part of the treatment?
Definitely not. Some clients do more conventional talk therapy. They discuss and work through what has happened to them and release some of their disturbance. This work in itself can be very therapeutic, particularly when combined with the psychoeducation and grounding practices mentioned above.
Is the traumatic event erased from memory?
No. The event loses its charge and “aliveness” but the memory remains accessible like any “normal” memory is. Clients generally want to remember what happened to them. Just not as if it’s happening again.
What does the psychoeducation have to do with the rest of the treatment?
This education is provided to encourage and clarify both the practices you’re shown and the EMDR desensitization you receive. Clients, for instance, find it helpful to know that orienting practices and EMDR desensitization treatment are both effective, in part, because they convey to the lower brain that the here-and-now is safe. Generally it is very helpful to remember, during treatment, that we are mammals whose bodies react in automatic ways under threat—fight/flight and freeze responses–and also humans whose mammal reactions and irrational thinking often get “unnaturally” locked-in following abuse/assault events.