Christiane Sanderson is a lecturer in Psychology at London University, Birkbeck College, and visting lecturer in the School of Human and Life Sciences, Roehampton University. With 21 years’ experience working in child sexual abuse interpersonal abuse and trauma, she has provided consultancy and training to parents, teachers, social workers, nurses, therapists, counsellors, the NSPCC and the Metropolitan Police Service.

Over the many years of working with survivors of interpersonal trauma I have come mindful of how transformative this clinical work is not only for the survivor but also for me as a practitioner. Being in the presence of individuals who have been repeatedly betrayed and still risk connection is something that I honour and value as a testament to both courage and hope.

The paradox of interpersonal trauma is that abuse masquerades as affection, which comprises internal and external reality and allows confusion to reign. The overwhelming nature of interpersonal trauma in which there is no escape activates a cascade of neurobiological chemicals as well primitive psychobiological defences and survival strategies such as dissociation, alterations in perception and withdrawal. Under threat of physical and psychological annihilation, the individual has to disavow basic human needs and aspects of the self. In essence abusers dehumanise their victims through their shameless brutality. In turn the survivor has no choice but to adapt to this by disallowing any human responses for fear of further abuse as they try to reconcile “Knowing what you are not supposed to know and feeling what you are not supposed to feel” (Bowlby, 1988).

In addition, the secrecy accompanying much interpersonal abuse prevents validation of the experience rendering it inchoate and ineffable. It becomes an experience that cannot be named, or legitimised, cast into an abyss of silence. In the absence of words it is impossible to generate meaning, or make sense of the trauma, and so becomes ossified as a nub of despair in which self, others and the world cannot be trusted. Thus, all relationships are seen as dangerous, suffused with terror, anxiety and anticipated re-traumatisation, making it hard to trust and connect to others, including professionals.

The pervasive fear of others makes it extremely difficult for survivors to seek professional help as to risk connection only to have their trust betrayed again becomes a major concern rendering many survivors highly suspicious, hostile and resistant to any therapeutic engagement. Practitioners need to honour survivors of interpersonal trauma who, despite repeated betrayals risk connection by engaging in a therapeutic relationship and see this as testament to hope in which the essence of the self has not been annihilated. What is critical is a genuine, sensitively attuned relationship which is predicated on authenticity and relational warmth in which the survivor can become human again.

As interpersonal trauma thrives on the distortion of perception, falsification of reality, disavowal of needs, and lack of relational authenticity, it is imperative that such dynamics are minimised in the therapeutic relationship. To undo the pervasive effects of interpersonal trauma, practitioners need to create a secure base in which to explore abuse experiences and enable the survivor to reconnect to the disavowed aspects of the self and rebuild trust in others.

To facilitate this, practitioners need to ensure they do not hide behind protocols and prescriptive techniques in order to create an authentic human relationship in which to truly understand their client and undo the dehumanisation inherent in interpersonal abuse. It is only in the ‘human to human’ relationship that intersubjectivity can be restored and the survivor can be released from the debasement of interpersonal abuse to permit post traumatic growth which allows both survivor and practitioner to access a deeper appreciation of what it is to be human and to be alive.

Copyright © Jessica Kingsley Publishers 2009

Christiane Sanderson is the author of Introduction to Counselling Survivors of Interpersonal Trauma. See the below link for more details.

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