Child Abuse, Trauma, and Psychological Loss
Abuse leads to a complicated form of grief and mourning
Posted Nov 09, 2018
Most abuse survivors experience psychosocial losses resulting from the traumas. These losses include loss of childhood, loss of innocence, loss of faith in God, loss of hope in a higher power, loss of family relationships, loss of self-esteem, loss of personal power, loss of self, and loss of the ability to feel pleasure in life. In sessions, clients express feeling a deep loss of “who I could have been if I had never been abused.” Sustained abuse impacts a child’s everyday life and many wonder if “I was not always in survival mode how I would be different.” Clients state that they feel they were not given or allowed the opportunity to develop their talents and to cultivate their real selves. They state that they feel that their “true self” was left dormant by years of surviving daily mistreatment and abuse.
A number of experts in the field have reframed post-traumatic stress as a form of complicated mourning. Therese Rando (1993), maintains that “all elements of post-traumatic stress are manifested in some way in both acute and uncomplicated grief and complicated mourning” (p. 58). The challenges that adult survivors experience are hopelessness, depression, anger, confusion, and negative beliefs about self and the world. These are similar to the symptoms seen in individuals who have not progressed in their mourning process and are in a state of chronic or prolonged grief. The term “bereavement overload” is a concept that can be used to describe the mental health status of survivors of long-term child abuse.
My client Louisa had a history of excessive childhood neglect and abuse, and it interfered with her ability to develop a sense of trust in herself and her world. Her basic mistrust in herself and others filtered through all aspects of her life. Louisa came into therapy as a 29-year-old mother of two preschool-age children. She was experiencing a great deal of emotional pain and was ashamed of her inadequate functioning as a mother and a wife. Through the process of therapy, Louisa became aware of how her childhood experiences were contributing to her present self-destructive behaviors, social withdrawal, feelings of despair, and impaired relationships with her children, husband, and extended family. Louisa felt that the distress she was experiencing was related to how restrictive her life had become. The experiences that Louisa described in therapy match the symptoms seen in people who have not moved through their mourning process and are, therefore, experiencing a state of prolonged grief.
In order to treat Louisa, we had to address the physical and sexual abuse and to examine the issues related to loss and grieving. Reframing Louisa’s experiences in the context of loss resonated with her and appeared to convey and match her internal experiences. Louisa had endured a tremendous number of losses in her life and did not have a safe arena to express and work through the grief of these losses. Louisa mourned that her PTSD symptoms were severely interfering with her ability to care for her children. She expressed intense emotional pain and feelings of grief, remorse, and self-disdain for not being able to protect her children from her own inadequacy as a mother, in particular, to be warm and attentive toward her children.
Child abuse survivors experience tremendous secondary losses in their lives. The severe and numerous losses that survivors experience and a lack of sufficient support systems complicate their attempts to resolve multiple traumas and associated grief responses. Due to the veil of secrecy that surrounds abuse, survivors do not feel safe to express and work through their grief and mourn their losses.
Rando, T. (1993). Treatment of complicated mourning. Illinois: Research Press.