When an adult has been repeatedly abused as a child, it affects every area of his/her life, especially  relationships. The damage to one’s physical, emotional, and spiritual health can be extensive. As a child, safety and security are major needs and when boundaries are broken repeatedly as in child sexual abuse, it affects sexual identity, self-esteem, and a person’s concept of being good or bad. In these cases of severe, repeated abuse and neglect, an adult survivor can suffer from Complex PTSD. That usually indicates that the survivor also has issues with abandonment and has attachment problems to work out as well.  The trauma needs to be processed, and reintegrated back into the psyche.

When trauma continues to be a part of the survivor’s life, or a lot of trauma occurs at the same period of time at the end of one’s life span, problems tend to multiply. Exhaustion is common as well as severe depression and overwhelming anxiety. As a human being, most of us want to be liked and respected by others. When a child has been abused and  neglected severely, the need to be liked, to be seen as a good person becomes intertwined with the need for safety, security, and love. The result can often be seen in the relationships that follow throughout one’s life span. Counseling can help the survivor form healthier relationships and educating oneself about relationships can help the survivor break the cycle of abuse in his own life and the lives of his/her children.

In the first part of this article, I discussed Valerie Kuykendall-Rogers article in GoodTherapy.Org. in which she coined the term: “wounded attachment” while writing about survivors of childhood sexual assault. She talked about the child learning to sacrifice his/her needs in order to make the abuser happy. The child is focused on pleasing, doing what the abuser wants in order to stay safe and secure, while hacking off pieces of himself to keep the peace. He/ she feels  he/she is not worthy of having his/her needs met. This reinforces the wounded concept of self in the survivor with future relationships. The survivor begins to believe the only way he can receive love and attention is to do what he is told to do regardless of the harm done to his own self-esteem. He learns another’s needs supersede his own because that person is more worthy than he is. He thinks he is bad, therefore he deserves nothing.

Later, if the survivor enters a psychotherapeutic relationship, It is critical that ” a good fit ” exists between he and his therapist for goals to be met. A survivor needs a therapist with skills in Complex PTSD. Being able to read the therapist’s nonverbal language will cut anxiety and enable him to feel safe. Understanding attachment difficulties in the survivor, his struggles with object constancy, and the survivor’s need for feedback and openness can help the therapist build a better foundation for trust between them. If the therapist is hard to read, gives little feedback, shows little emotion, it will increase anxiety, depression, and increase the likelihood of transference which can become intense. A warm, empathic therapist will also make the relationship easier to navigate. The therapist  needs to be able to empower the survivor and not take all the control. He also needs to be able to understand ” wounded attachment” and be aware of the survivor’s need to be liked in order to feel safe. He needs to be careful to put the client’s needs first and validate the survivor’s strengths and be accepting of his weaknesses until the survivor learns new skills for regulating emotion and how to problem solve in a more effective way. If “wounded attachment’ gains a foothold in the therapeutic relationship, it will damage the survivor’s self-concept, decrease his self-esteem, and increase self-hatred. This can cause difficulties in meeting therapeutic goals.

Yu/stan/ kema.