Living through a period of physical, sexual, or severe emotional abuse can leave psychic wounds that can be harder to heal than a bodily injury. Whether the abuse was inflicted as a child or an adult, survivors often struggle to cope and lead happy, peaceful lives. Therapy is a proven aid in understanding, expressing, integrating, and letting go of the pain and confusion that may stem from abusive experiences. Intense, often negative feelings are not uncommon, and survivors of abuse should understand that having difficulty coping with upsetting memories, blocks to intimacy, anxiety, and other remnants of abuse is fairly typical, and can be worked through, in time, with good therapy.

Types of Abuse

All types of abuse are painful and can cause psychological wounds. Often, a victim of abuse will experience more than one type of abuse. Below are several different types of abuse:

• Domestic Violence / Intimate Partner Violence
• Emotional / Psychological Abuse
• Physical Abuse
• Sexual Abuse
• Abuse of Power

Potential Psychological Repercussions from Abuse

Not all of the following challenges result from being abused, and abuse does not always lead to significant emotional or psychological problems. However, here are some typical psychological concerns that people who have been abused may face:

• Anxiety: People who have experienced abuse may be afraid of people or situations that remind them of their abuse experiences. They may be scared to be alone or of the dark, frightened of strangers, fearful in sexual situations, or intensely triggered by anger, depending on the nature of the abuse they experienced. Disrupted sleep, compulsive behaviors, panic attacks, and other indications of anxiety are somewhat common in survivors of abuse.
• Anger: Survivors of abuse may feel great anger at their abusers, at anyone who knew of the abuse but did not stop it, at people who remind them of the abuser, and even at themselves for being abused (sometimes believing they could or should have stopped it). Anger is not an inappropriate response to being abused; dealing with anger in a constructive way is a good goal for an abuse survivor in therapy.
• Dissociation: People who have been victims of abuse may find themselves numb, or experiencing a feeling like being out of one’s body, floating above oneself, and even forgetting where or who one is. These experiences may have begun while the abuse was occurring as a way for the victim to avoid the intense pain and fear that can be caused by abuse. Also, memories of abuse may be repressed, so that the victim does not have any conscious memory of the abuse. However, this is actually quite rare, and everyone should be cautious about concluding that abuse occurred in the absence of clear memories of the survivor.
• Mood Issues: Depression and/or mood swings is a somewhat common response to abuse.
• Posttraumatic Stress: Survivors may find themselves having nightmares, being on alert at all times, experiencing flashbacks, or otherwise reliving their abuse. They may avoid situations that remind them of the abuse.
• Shame: Victims of abuse often feel guilty or ashamed about their abuse, sometimes even believing that they deserved it, brought it on themselves, or should have been able to stop it. Examining and challenging such illogical beliefs is an important part of therapy for survivors of abuse.
  
• Self-Destructive Behavior: People who have experienced abuse may cope with conflicting feelings by self-medicating or engaging in self-harming behaviors. For example, they may act out their abusive situations compulsively, finding themselves again and again in similar relationships. They may avoid success and sabotage themselves, revealing deeply wounded self-esteem and difficulty caring for themselves. Survivors of sexual abuse sometimes allow their hygiene and health to deteriorate, perhaps unconsciously believing that this will make them less attractive to perpetrators.
• Trust Issues: Survivors may have great difficulty trusting others, especially in intimate situations, even if the survivors recognize that a certain person deserves trust and that the survivor’s mistrust is not entirely rational. A positive relationship with a therapist can go a long way to reversing this stance.

Psychotherapy for Abuse Survivors

Abuse in any form can have a significant negative impact on an individual’s life. Children who have been sexually, psychologically, or physically abused often experience emotional problems that can affect their school performance and/or social skills. As adults, survivors of abuse may experience difficulty with employment, parenting, and/or maintaining healthy relationships. Many survivors must cope with serious psychological issues, such as:

• Anxiety
  
• Depression
• Posttraumatic stress
• Panic
• Aggression
• Abandonment fears

Psychotherapy that addresses these issues can help survivors of abuse lead more fulfilling lives.

Delivered in a group of people, group therapy for people who have experienced abuse can be an extremely cathartic experience. Individuals who feel different, ashamed, or guilty as a result of the abuse will benefit immensely from discovering other people who have lived through similar experiences. Working one on one with a therapist provides a more intimate and personal platform for someone who may not be comfortable revealing their emotions, or someone who may be too traumatized by the abuse to share their feelings with others. Either way, psychotherapy focuses on addressing the emotions related to the abuse and helps the client work through distorted perceptions resulting from the abuse, such as guilt and shame. Clients who receive therapy for the abuse learn how to manage the emotions related to the abuse in an adaptive way and begin to develop new responses and behaviors. Using meditation, mindfulness, trauma relief, behavioral transformation, and other techniques, psychotherapy can empower a client so that they may move away from the consequences of the abuse and forward toward the life they desire.

Middle Age Woman Recovering From Sexual Abuse - Case Example

Patricia, 45, seeks therapy because she is in her first sexual relationship after more than two decades of avoiding intimacy. As a teenager, she was sexually abused by a male relative and feels great anxiety and anger whenever a man shows sexual desire for her. She has recently met a man who seems safe and compatible, but she does not trust her judgment. She is also very triggered, almost to the point of having panic attacks, anytime he initiates physical intimacy. Learning relaxation skills, exploring ways to take care of herself and stay physically and emotionally safe, and achieving some catharsis of her grief and anxiety allows her not to escape her fears and triggers, but to be able to move forward in the relationship in the presence of such triggers. Eventually Patricia develops a deeper level of trust not just with her partner, but with human beings in general--although anxiety remains an issue for her for many years, diminishing slowly in stops and starts.

Therapy for Ashamed Man Abused by Parents - Case Example

David, 27, was physically and emotionally abused by his parents as a boy, and feels great anger and shame. He has a need to understand why this happened to him, and cannot shake the sense that he must have deserved it. Cognitive behavioral therapy helps David to reality check his beliefs, and he begins to see his parents as the imperfect people they really are. This allows him some way to forgive himself, greatly improving his mood and self-image.

Patterns of Abusive Romantic Relationships - Case Example

Julie, 32, has been in and out of several abusive romantic relationships with women over the last decade. She recognizes the pattern but continues to forgive abusive behaviors by her partners and blame herself for their actions. Therapy helps her see how her abusers are like her mother, and this insight alone improves her ability to set boundaries. The support of her therapist, over about a year, helps Julie to accept her own needs as legitimate and begin advocating for herself with her partners.

Young, Abused Boy in Foster Care - Case Example

Devon, 12, was severely beaten by caretakers and has little ability to form healthy attachment to adults. He picks on other children at school and has been shuffled around the foster care system. His current caretakers want to adopt him, but only if they can find a way to manage his behaviors and win his trust. Family systems work with an experienced family therapist begins to alter the dynamics of the family’s interactions, and after many years of intense and difficult sessions, Devon is able to feel that he is safe.

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Last updated: 05-14-2013