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Recovery and Healing from Abuse and Trauma

by Sam Vaknin

Victims of abuse in all its forms - verbal, emotional, financial, physical, and sexual - are often disorientated. They require not only therapy to heal their emotional wounds, but also practical guidance and topical education. At first, the victim is, naturally, distrustful and even hostile. The therapist or case worker must establish confidence and rapport painstakingly and patiently.

Victims of abuse in all its forms - verbal, emotional, financial, physical, and sexual - are often disorientated. They require not only therapy to heal their emotional wounds, but also practical guidance and topical education. At first, the victim is, naturally, distrustful and even hostile. The therapist or case worker must establish confidence and rapport painstakingly and patiently.

The therapeutic alliance requires constant reassurance that the environment and treatment modalities chosen are safe and supportive. This is not easy to do, partly because of objective factors such as the fact that the records and notes of the therapist are not confidential. The offender can force their disclosure in a court of law simply by filing a civil lawsuit against the survivor!

The first task is to legitimize and validate the victim's fears. This is done by making clear to her that she is not responsible for her abuse or guilty for what happened. Victimization is the abuser's fault - it is not the victim's choice. Victims do not seek abuse - although, admittedly some of them keep finding abusive partners and forming relationships of codependence. Facing, reconstructing, and reframing the traumatic experiences is a crucial and indispensable first phase.

The therapist should present the victim with her own ambivalence and the ambiguity of her messages - but this ought to be done gently, non-judgementally, and without condemnation. The more willing and able the abuse survivor is to confront the reality of her mistreatment (and the offender), the stronger she would feel and the less guilty.

Typically, the patient's helplessness decreases together with her self-denial. Her self-esteem as well as her sense of self-worth stabilize. The therapist should emphasize the survivor's strengths and demonstrate how they can save her from a recurrence of the abuse or help her cope with it and with her abuser.

Education is an a important tool in this process of recovery. The patient should be made aware of the prevalence and nature of violence against women and stalking, their emotional and physical effects, warning signs and red flags, legal redresses, coping strategies, and safety precautions.

The therapist or social worker should provide the victim with lists of contacts - help organizations, law enforcement agencies, other women in her condition, domestic violence shelters, and victims' support groups both online and in her neighbourhood or city. Knowledge empowers and reduces the victim's sense of isolation and worthlessness.

Helping the survivor regain control of her life is the over-riding goal of the entire therapeutic process. With this aim in mind, she should be encouraged to re-establish contact with family, friends, colleagues, and the community at large. The importance of a tightly-knit social support network cannot be exaggerated.

Ideally, after a period of combined tutoring, talk therapy, and (anti-anxiety or antidepressant) medications, the survivor will self-mobilize and emerge from the experience more resilient and assertive and less gullible and self-deprecating.

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