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An Eloquent Champion for Survivors of Sexual Abuse

source: Margot Silk Forrest

Dr. John Briere Teaches Therapists to Honor and Respect Survivors

Editor’s Note: I wrote this article in 1992 after attending a number of workshops for therapists who work with survivors. I was struck by the wisdom and the caring of the women and the men I heard—people who devote a good chunk of their lives to sharing their knowledge about survivors of childhood sexual abuse and the healing process. One of the most eloquent and energetic of these people was Dr. John Briere. The following article is a selection and interweaving of remarks from several of Dr. Briere’s workshops and lectures that I attended.

John Briere, Ph. D., is a trauma specialist, a therapist, a researcher, and the author of over 40 professional articles and three books on working with adult survivors of child abuse. He is also a frequent lecturer to professional groups, giving several workshops a month across the U.S. on working with trauma survivors, especially survivors of childhood sexual abuse. Dr. Briere is a psychiatry professor at the University of Southern California School of Medicine.

Here are some excerpts from his talks and workshops.

Survivors of abuse are victims of a social phenomenon and are revictimized by society in at least two ways. First of all, adult survivors’ histories of childhood pain and injuries are often discounted and ignored. Thus the logical connection between adult survivors’ experience and child victims’ experience is ignored, and so the healthy connection between the two is ignored. Which means that because we have tried not to look at child abuse, when we look at adults in pain, we treat them as if they are illogical, irrational and sick, because we have no other way to explain what we are choosing not to see. The second effect is that survivors end up in many cases being defined by their injuries, their symptoms, rather than by their strengths and their wisdom.

Our culture has given survivors so few places to go for any kind of affirmation, which is such a sad discrimination.

The reality in our culture is not whether you are abused as a child, but how you are abused and how much you are abused. … Just as an individual person can dissociate from trauma and make it not happen on some level (even though it continues to hurt them)…so our culture has partitioned off survivors so that it can function as if nothing is wrong. Survivors are actually a repressed part of our culture… What our culture does to survivors is to de-real-ize them. It says, “That’s not real. That didn’t happen. You haven’t been hurt.” What’s the experience of being de-real-ized by the culture? You think you must be crazy.

One of the great things about human beings is that if we don’t get it right the first time, we just keep doing it over and over again. You may want to call it re-enactments [or repetition compulsion], but in reality it is an adaptive response to try to get it right, to do it until you get it right.

The vast majority of things we see as symptoms in abuse survivors are survival strategies. … I think most people who are labeled as addicts of one kind or another are abuse survivors—they engage in these behaviors to reduce pain.

There’s strong data showing that many people who use alcohol and drugs are child abuse survivors. They are trying to deal with pain by moderating it through chemistry.

I would submit to you that all these behaviors [alcohol and drug addictions, eating disorders, self-mutilation, sexual acting out] are tension-reduction behaviors, and what they actually represent are ways in which the survivor can use external methods to control internal pain.

If we ignore child abuse, as far as I’m concerned, we’ve ignored one of the major causes of psychiatric disorder in our culture. If we could stop child abuse and neglect tomorrow, two generations from now we’d only have organic disorders, schizophrenia, bipolar affective disorder, adult trauma reactions, and a couple of kinds of major depression. Or, at least, there would be so much less distress than now that the DSM [the 567-page diagnostic manual used by therapists] would shrink down to a pamphlet.

The DSM-III-R, the diagnostic handbook used by millions of therapists, makes one single reference to child abuse—three words—in the section on dissociative disorders… That’s frightening. You can pick up a textbook of psychopathology and look at “abuse” in the back and only find “abuse, substance.” Remember that in 1975 the Comprehensive Textbook of Psychiatry stated that the likelihood of incest in the general population was one in one million people.

I do not personally believe that anything going on right now on any remedial level in any area of our social system [such as police, prisons, etc.] is going to change our social problems. I think in every generation there’s going to be more violence, more abuse, more substance abuse, more pain. We have not touched the central problem. And it will only improve when we address child abuse.

I believe that abuse survivors represent the very worst [for instance, when they become perpetrators] and the very best that our culture has to offer: Virginia Woolf was a survivor, Frederick Douglass was, Marilyn Monroe was.

I think what we need for the future are people who’ve seen what’s wrong with “normal” development by having been a victim of it, and who have moved beyond that to a point of creative deviance, a point of being unwilling to buy what has always been bought and instead to try something new.

Never before in our history has psychotherapy been addressed specifically to the abuse survivor. I think this probably marks the first generation of what may be an important change in our culture. That is, survivors who have been there and said, “I’m not going to [sexually abuse] my kid, I’m not going to hit my kid, I’m not going to be mean to people ‘cause I’m in a bad mood, and I’m not going to drive by the homeless.”

This is the first generation in all human history where we have the concept of the healed survivor. I am hopeful that this will escalate and that ultimately the healed survivor will be the person who is our political leader, our scientist, our healer.

Who in the world is going to better know what not to do than someone who’s had it done to them? It may be ultimately that our culture needs to depend on the people it hurt.

I don’t believe that you can be truly “healed” from sexual abuse any more than you can be “healed” from rape. I don’t mind the word, and I don’t wince when other people say it. But I think what we do is we change our relationship to the event, we don’t change the event. You will always have been raped, you will always have been beaten up; the difference is what it means to you, how you relate to it, your experience of it, whether you have integrated what it did to you, whether you’ve changed how you respond to it.

The good news is therapy does work, even for severe sexual abuse trauma. I really mean that. I’m thinking about several people who I work with, some of whom are in their third or fourth year [of therapy] right now, who are still not all the way “better” but who have come so far.

It’s a sad but unavoidable fact that when you take kids and you hurt them real bad when they’re little, they’re going to grow up being hurt, and it’s going to take a long time to help them.

[To therapists:] If you could truly listen to what a lot of people have experienced in their childhoods…the fact that they’re here now is…truly an awesome notion.

Don’t treat symptoms as if that’s the problem… The symptoms are the problem-solving device…. What you have to do is treat the problem. The symptom is information about what happened [to the survivor].

It seems pretty amazing that people could have ulcers or high blood pressure about dangers that stopped happening 30 years ago. But therein lies the rub. It didn’t really stop happening 30 years ago. To paraphrase Oscar Wilde, the past isn’t even the past, it’s now.

It’s very important that survivors hear about the incidence of abuse, the effects of abuse. Can you see how normalizing that is? You’ve got 37 things in your life that are horrible and you think you have 37 problems. Then you read a book and it lists all 37 problems. It’s due to one thing. You don’t have 37 problems, you have one thing, and that one problem wasn’t your fault. That can be tremendously uplifting.

We’ve been tricked into thinking therapy is about recovering the memory: If you can get the memory you can work with it. We’ve got it backwards! It’s this way: as the client gets better, they have the memory. It’s not that they have the memory and then get better.

Some therapists think, “Well, you’ve got to be angry at your perpetrator. Therefore, I’ll make you angry at your perpetrator.” They’re getting it backwards. You don’t need to be angry at your perpetrator. When you get strong enough and are healthy enough, your anger comes out and is exposed. … I don’t need to make you angry so you can work through your abuse. You need to work through your abuse so you can be angry.

A very important part of work with abuse survivors is how you respond to them. The bottom underlying issue is do you treat them with respect, do you provide safety, and do you honor the dignity they bring to the session—a dignity they may hide from you because they’re scared of it, they think they don’t deserve it. A lot of what psychotherapy has to do is this notion of honoring the dignity and the need for safety that the survivor has.

I think that we as therapists sometimes underestimate the massive amount of bravery that must be inherent in anyone who’s been hurt a lot going to seek therapy. You [the survivor] have spent your whole life avoiding pain, and therapy is about getting into that pain.

[Working with survivors] is about hope and strength and perseverance and the indomitable…human spirit.

Copyright © Margot Silk Forrest
Reprinted With Permission


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