Child abuse remains a common problem that is experienced by millions of Americans. Approximately 1 in 10 children report some form of maltreatment by a caregiver, which translates into more than 30 million victims of child abuse in the country. Adverse childhood experiences have lasting effects too. Research shows that the health effects can last for decades following high levels of child abuse and other adversities during childhood, ranging from natural disasters to having an alcoholic parent..
The good news is that many people overcome these experiences. We can learn from the experiences of those who have learned to survive and even thrive after a history of child abuse and adversity.
Our traditional approaches to therapy too often miss the point and, frankly, aim too low. No one defines their hopes and dreams for their lives in terms of "not meeting criteria for clinical depression" or the absence of any other mental health problem. Humans seek happiness and belonging and general well-being. Of course, individual experiences vary. One of the biggest factors in the challenges of healing from abuse is the "dose"—how much abuse and adversity a person has experienced. The number of perpetrators and the number of dangerous settings also make a difference. More perpetrators and more dangerous settings (that is, not safe at home, school, or in the community) make it more challenging to heal. Still, even some people who have experienced a lot of abuse learn to heal. What heals?
1) Telling your story. Probably the single most effective healing step someone can take is to write a narrative. Sometimes these are called "trauma narratives" and they have some of the best research supporting them of any therapeutic technique. I prefer the term "values narratives" and an approach to narrative that focuses not only on the trauma but how that can fit into your broader identity, personal values, and who you want to be.
The human brain is built for storytelling. Telling your own story can help you organize what happened to you and put it into the big picture of who you are. It improves something that psychologists call "narrative coherence." Another benefit is what psychologists call "emotional clarity." Here is how one narrative writer put it:
"I like writing, it helped me kind of, I think writing the last one I wrote helped me more understand what happened in the experience, I've never really like sat down and recalled it all, and it helped me do that… I think it's helped me reflect on it, more than shape it. It's helped me to understand what's gone wrong, or what's gone right, and helped me be thankful for more things."
2) Helping others. When I give presentations to providers, I like to talk about how none of us are "zeroes" when it comes to childhood adversity. Yes, there are important, very important, differences in the severity of childhood adversity. As I mentioned, the latest research suggests that the overall "dose" and especially the number of different types of abuse or other childhood problems appears to make the biggest difference in the psychological impact.
However, it is also important to realize that there are very few people who survive to adulthood without any experience of adversity. All of us eventually experience loss and hurt—major loss and significant hurt. Unfortunately, in our professional roles we often pretend that is not the case and I believe that leads us to miss some important insights into what helps people overcome adversity.
Giving back to others is so important to virtually every psychologist, social worker, police officer, or health care provider. It is the way that many of us have overcome our own childhood experiences and worked to interrupt the cycle of violence. Which is why it is all the more ironic that psychotherapy and most other interventions for abuse or adversity hardly ever focus on generosity, community involvement, and social support. That needs to change. Shifting the focus onto relationships with others is healing for many people.
3) Activism. One particular form of giving back that is important to many is activism. This can take any number of forms. It can mean volunteering—for any number of causes—at community agencies. It can mean serving on the board of directors or as an advocate or as a guardian ad litem or in a number of other roles in agencies that specialize in helping victims of abuse and violence. It can include becoming involved with national political organizations or contacting your members of congress about policies that help those who were mistreated as children. It can include donating money or other items to various nonprofits or churches. You will probably find that many of the people in these organizations were inspired to do that work because of their own experiences or how abuse or other adversity affected their loved ones. They find meaning in what they went through by working to prevent it from happening to others.
4) Re-thinking the focus of short-term therapy and other brief interventions. These days, many people only have access to short-term therapy, often not more than 6 to 8 sessions. It's a mystery why these services are still organized in ways that are reminiscent of the days when therapy often lasted a year or more. A few leaders in the field are starting to encourage many providers and agencies to think about using those 6 to 8 weeks as a time to mobilize other resources and support. Most therapists cannot—and should not—be sources of long term social support. However, even in 6 weeks a therapist can help a client reach out to family, friends, co-workers, fellow church members, or others. A therapist can help a socially isolated client join a support group or enroll in a class.
5) Improving self-regulation. Finally, as adults healing from childhood wounds, one of the best things we can do for ourselves is improve our self-regulation. Improving self-regulation means a lot of different things. It means learning to manage our emotions and to gain more control over the difference between having a feeling or thought and acting on it. It's almost impossible and also unwise to try to control thoughts and feelings. Like the old challenge of not thinking about a pink elephant. That is one reason that narrative interventions help, they help you express and organize thoughts and feelings instead of suppressing them. Behaviors can and should be controlled, from excessive use of alcohol or drugs to our own angry impulses. Improving emotional endurance, diligence, and grit are also paths to success and happiness for many people.
All of these different approaches and many others too numerous to include here are all focused on the same goal: getting to a place where you can acknowledge what happened to you and also acknowledge that there are many other important parts of your identity. We are all more than the sum of our bad experiences.
© 2014 Sherry Hamby