Sexual abuse, erotic transference and how to deal with panic attacks

Our second weekend on sex involved discussing sexual abuse, erotic transference and how to deal with panic attacks. There were lots of opportunities to discuss the practical aspects of our client work which was very helpful. We also referred to the BACP Ethical Framework. It was perhaps an appropriate time to have this weekend when the BBC is discussing how to deal with the Jimmy Saville affair.  

The following definition for sexual abuse was tabled. Sexual abuse of children and young people occurs when any person forces, tricks, coerces or threatens a child to have any kind of sexual contact with him/her. Jan Sutton provides the following definition: the involvement of a young person, who has not reached intellectual and emotional maturity, in any kind of sexual activity that breaks the laws of the EU. Particularly any sexual activity that is imposed on a child by any person who is more powerful because of their age or position of authority that violates the sexual taboo of the family or of the community to which the child belongs.

Sexual Abuse includes:

1. Rape
2. Buggery
3. Forced sex with animals
4. Being bathed, kissed or cuddled in a way that makes a child feel uncomfortable
5. Made to have oral sex
6. Forced to listen to sexual talk
7. Penetrated by an object/fingers
8. Unwelcome sexual advances
9. Made to watch sexual acts
10. Being masturbated or forced to masturbate someone
11. Being involved in pornography
12. Made to eat/drink urine, semen, faeces
13. Child prostitution
14. Ritual/satanic abuse

An important exercise for anyone but particularly therapists is to get in touch with one’s own shame.  We did a lot of really useful role-play on intimacy. What are we ashamed about in our past?  Have we dealt with our baggage in order to be effective in the therapeutic alliance.

We had a valuable discussion on how to deal with someone undergoing a panic attack.  Clients might easily get in touch with early trauma when recollecting childhood memories in therapy.  It is critical to understand the physiology of panic attacks and to understand that deep slow breathing from the stomach is required in order to deal with the panic attack.

Erotic transference

We go into therapy because of some form of deficit of some description in our lives.  Therefore, when as therapists we practice unconditional positive regard, the potential for clients to feel loved and to mix these feelings up with actual love is high.  Infantile needs can be the foundation for the creation of erotic attachments.

We were given advice on how to manage erotic transference as therapists:

1. Check what is happening
2. Face up to it
3. What is my part?
4. Bring awareness to client
5. Conceptualise what is happening.

The best guideline for maintaining boundaries seems to be to have your own life as a therapist where your own intimacy needs are being met. Supervision should be a safe place to discuss all the feelings that get aroused in client work however uncomfortable.

According to Paul Croal, the psychology of our desire (or indeed lack of) often lies buried in the details of our childhood. Digging through this early history often uncovers its archaeology. Through this history we learn to love. I see sex as a narrative and part of the self. It’s similar to our image in that it contains the positive and negative aspects of the self. If for example Mum was distant and depressed how will that show up in our arousal template? Our sexual preferences arise from the thrills, challenges and conflicts of our early life. How these bear on our threshold for closeness and pleasure is the object of our excavation.

Resources

Click here for a self assessment tool if you are worried about your sexual behaviour. She is a trainer on the UK’s first Professional Certificate in Sex Addiction Treatment.

My extended interview with systemic psychotherapist, social worker and researcher DrMarie Keenan,  author of Child Sexual Abuse and the Catholic Church Gender, Power, and Organizational Culture. Dr. Keenan’s most recent research involves a study of Roman Catholic clergy who have sexually abused minors. Her research centres on the men’s accounts of how it came to be that they sexually abused minors and their understanding of the conditions of their lives that contributed to this problem. Click here to listen again to the Dr Marie Keenan interview.

Paula Hall is a UK based sexual and relationship psychotherapist. Paula has been specialising in the field of sex addiction for over 10 years and has trained withThaddeus Birchard in the UK and with Dr Patrick Carnes in the US. Paula is a founder member of ATSAC (Association for the Treatment of Sex Addiction and Compulsivity).  In the interview we discuss the nature of sex addiction, the treatment models for sex addiction, 12 step recovery programmes,  psychotherapeutic modalities and her plans for book on sex addition and treatment. Click here to listen again to the Paula Hall interview.

NSPCC: Advice and support for adults concerned about a child
Police: Emergency and non-emergency police services
Mosac: Support for non-abusing parents and carers
Sex Education Forum: Information about sex education
Stop it Now: A campaign for preventing child sexual abuse